Treatment of Xanthelasma Palpebrarum With 90% Trichloroacetic Acid: A Case Series

DOI

10.2991/978-94-6239-836-8_18How to use a DOI?

Keywords

Xanthelasma palpebrarum; trichloroacetic acid; case series; chemical cauterization; dyslipidemia

Abstract

Xanthelasma palpebrarum is the most common cutaneous xanthoma and typically presents as yellowish plaques in the periorbital region. Although several therapeutic modalities are available, an inexpensive and technically simple treatment remains desirable, particularly in settings where laser or surgical procedures may not be readily accessible. Trichloroacetic acid (TCA) causes controlled chemical coagulation of tissue and has been used for the treatment of xanthelasma. This case series describes the clinical outcomes of 90% TCA treatment in patients with xanthelasma palpebrarum. This retrospective, single-center descriptive case series included 10 patients with clinically diagnosed xanthelasma palpebrarum treated with topical 90% TCA at Skin Clinic, Lhokseumawe City, Aceh, Indonesia, between October 2021 and June 2023. TCA was carefully applied directly to the lesions using a small wooden applicator until visible frosting developed. Patients underwent one to three recorded TCA applications, with some applications performed at different lesion sites, according to lesion distribution and clinical response. Treatment response and adverse effect were assessed clinically during follow-up and supported by serial clinical photographs. Written informed consent was obtained from all patients prior to treatment and for the use of their clinical data and photographs for scientific publication. Ten patients (nine women and one man), aged 32–60 years, underwent treatment with 90% TCA. Six patients underwent one recorded treatment session/application, two underwent two, and two underwent three, with repeated applications in some patients performed at different lesion sites. All 10 patients showed visible clinical thinning of the treated xanthelasma lesions during follow-up. One patient experienced an adverse effect in the form of scarring, post-inflammatory hyperpigmentation and one patient experienced crusting. Topical 90% TCA was associated with visible clinical improvement of xanthelasma lesions in this case series and represents a relatively simple and low-cost treatment option. Further prospective studies using standardized clearance scores, safety assessments, and longer follow-up are required to determine treatment effectiveness and recurrence rates.

Copyright

© 2026 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Mohamad Mimbar Topik
PY  - 2026
DA  - 2026/11/11
TI  - Treatment of Xanthelasma Palpebrarum With 90% Trichloroacetic Acid: A Case Series
BT  - Proceedings of the3rd Malikussaleh International Conference on Health and Disaster Medicine 2026  (MICOHEDMED 2026)
PB  - Atlantis Press
SP  - 195
EP  - 207
SN  - 2468-5739
UR  - https://doi.org/10.2991/978-94-6239-836-8_18
DO  - 10.2991/978-94-6239-836-8_18
ID  - Topik2026
ER  -