Bichloracetic Acid for Treating Xanthelasma

Treatments for xanthelasma have included surgical excision, cryosurgery, electrodesiccation, CO₂ laser ablation, and chemical cauterization. These have had initial success but are associated with a high rate of recurrence and occasional side effects, including scarring, hypopigmentation, and ectropion after excision. In this series of 13 patients, 8 of whom had elevated cholesterol, 100% bichloracetic acid (BCA) was used to treat 25 xanthelasma. The acid was not neutralized after application.

Xanthelasma cleared completely in 85% of patients after either one treatment or a touch-up treatment two months later. Lesions in the remaining two patients, both of whom had elevated cholesterol, cleared only partially. Of the completely cleared lesion…