Journal of the American Academy of Dermatology
Treatment of solar lentigines
Section snippets
Cryotherapy
Cryotherapy is one of the most widely used techniques to remove solar lentigines, particularly in Western Europe and the United States. The technique can be used with a number of cryogens, including carbon dioxide, nitrous oxide, and liquid nitrogen. The most commonly used agent is liquid nitrogen, either applied with a cotton swab or more commonly with a small hand-held spray unit. The principle of the treatment in solar lentigines is tissue injury by cell freezing. Melanocytes are especially
Topical therapy
A range of topical therapies are currently available for the treatment of solar lentigines. The principal mode of action is the disruption of melanin formation. Hydroquinone (HQ) and tretinoin (retinoic acid [RA] or vitamin A acid) are the most widely used agents for the treatment of hyperpigmentation; other topical agents that have been used as monotherapy or in combination include mequinol (4-hydroxyanisole [4HA]), adapalene (synthetic retinoid), and azelaic acid. HQ inhibits the conversion
Recommendations
The PDA has reviewed the literature on treatment of solar lentigines and categorized the clinical findings for each treatment according to guidelines adapted from the US Preventive Services Task Force (USPSTF) on health care (Table II, Table III).37
As a result of reviewing the clinical evidence, as shown in Table II, Table III, the PDA has categorized each therapeutic option for solar lentigines as shown in Table IV.
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Supported by Galderma International.
Disclosure: All authors are members of the Pigmentary Disorders Academy (PDA) and receive honoraria from Galderma for their work on behalf of the Academy.