Comparison between Peeling with Focal Trichloroacetic Acid and Quasi-Continuous Frequency-Doubled Nd:YAG (532 nm) Laser in the Treatment of Freckles

Background: Benign pigmented lesions, including freckles, are common and various treatment modalities including lasers and peeling have been evaluated for their effectiveness in their treatment.Objective: To compare the clinical effects of focal peeling with Trichloroacetic Acid (TCA) and Nd:YAG (532 nm) laser on freckles.Methods: Twenty patients with freckles were treated with focal peeling with TCA 25% on their left-sided lesions and Nd:YAG (532 nm, Fluence 9.5 J/cm2, spot size 1.5 mm) on their right-sided lesions. Photographs were taken prior to treatment and at follow-up visits and were evaluated by three dermatologists and the results were analyzed.Results: Eighteen out of the 20 patients (90%) with freckles manifested more than 50% improvement in laser treated areas whereas clinical improvement in focal peeling treated areas was observed in 15 out of 20 (75%). The mean improvement rate for laser and focal peeling was 66.50±12% and 58.3±15%, respectively. No significant difference was observed in the treatment results between these modalities.Conclusion: Focal peeling with TCA 25% could be as effective as frequency-doubled Nd:YAG (532 nm) laser in the treatment of freckles.