Efficacy and safety of cryotherapy vs. trichloroacetic acid in the treatment of solar lentigo

Background Solar lentigines are common sun‐induced benign melanocytic proliferation that presents a significant cosmetic worrying for many middle‐aged and elderly patients. Although the newer photoselective lasers have become the mainstay of treatment, cryotherapy and trichloroacetic acid (TCA) solution are inexpensive alternatives in the treatment of solar lentigines. The purpose of this study was to assess the efficacy of cryotherapy compared with TCA 33% on solar lentigines of the back of the hands (SLBH) in patients presenting to dermatologic clinic of our hospital. Methods Each hand of 25 women with SLBH was treated randomly with either cryotherapy or TCA 33% solution. Photographs of the hands were taken prior to and 2 months following the treatment. The response and side‐ effect rate were compared. Results Cryotherapy was more likely to produce substantial lightening of the solar lentigines than TCA 33% solution (P = 0.025) but more painful and took more time to heal. Post‐inflammatory hyperpigmentation (PIH) was almost equal in two types of treatment (P > 0.05). Statistically, the better results were seen in fairer Fitzpatrick's skin types (P = 0.00). Conclusion Cryotherapy shows better results than TCA 33% solution in the treatment of SLBH particularly in lower Fitzpatrick skin types. PIH is the major complication of each type of treatments particularly in darker Fitzpatrick skin types. Generally, the major criterion for treatment of SLBH with cryotherapy or TCA is Fitzpatrick's skin type of patients.