A comparative study of focal medium-depth chemical peel versus cryosurgery for the treatment of solar lentigo.

Recently, focal chemical peels with trichloroacetic acid (TCA) have been introduced for the treatment of pigmentary disorders to minimize the side effects such as pain or scarring associated with medium-to-deep chemical peeling. This is a controlled, prospective study to compare the efficacy of a focal medium-depth chemical peel regimen using 70% glycolic acid and 35% TCA with cryosurgery, in the treatment of solar lentigines of the hands. Twenty-five patients were treated with either focal medium-depth chemical peel or cryosurgery, which was randomly assigned to the left or right hand. Clinical improvement was graded by the three blinded investigators 2-months after the treatment. In the focal medium-depth chemical peel treated side, clearing was achieved in four out of 23 patients (17.4%) compared with five out of 23 patients (21.7%) in the cryosurgery treated side. Statistically, the difference between the clinical improvement of solar lentigines with chemical peel and cryosurgery was not significant, according to chi-square test (p = 0.940). However, we suggest that treatment of the solar lentigines with a focal medium-depth chemical peel may be clinically superior to treatment with cryosurgery, due to the paucity of side effects, such as hypopigmentation and pain, associated with the chemical peel regimen.