Comparison of efficacy of cryotherapy versus trichloroacetic acid in the treatment of solar lentigo on hands

Background and aim: Solar lentigines are common sun-induced benign melanocytic proliferations that present a significant cosmetic problem for many middle- aged and elderly patients. The purpose of this study was to assess the efficacy of cryotherapy in comparison to trichloroacetic acid (TCA) 33% on solar lentigines on the back of the hands (SLBH).Materials and Methods: Each hand of 33 patients with SLBH was treated randomly with either cryotherapy or TCA 33% solution. Photographs of the hands were taken prior to and two months following the treatment. Therapeutic response and side-effect were compared using chi-square test.Results: Twenty five patients completed the study. Cryotherapy was more likely to produce substantial lightening of the solar lentigines than TCA 33% solution (P=0.025) but was more painful and took longer to heal. Post inflammatory hyperpigmentation (PIH) was almost equal in two types of treatment. Statistically, better results were seen in lower Fitzpatrick's skin types (P<0.01).Conclusion: Cryotherapy appears to be superior to TCA 33% solution in the treatment of SLBH particularly in lower Fitzpatrick skin types. PIH is the major complication of both particularly in higher Fitzpatrick skin types. Generally, the major criterion for treatment of SLBH with cryotherapy or TCA is Fitzpatrick's skin type.