This article is more than 5 years old. Information may no longer be current.

Triple-combination cream comparable to laser in treating solar lentigines

Q-switched ruby laser and triple-combination therapy cream were effective in reducing solar lentigines; however, the laser provided faster and longer-lasting results, according to recently published study results.

Researchers in Zurich, Switzerland, treated 15 patients (14 women; mean age, 61 years) with symmetrically distributed solar lentigines on the back of both hands. The back of the right hand was treated with one or two sessions with the SINON quality-switched (Q-switched) Ruby laser (wavelength 694 nm; 4 J/cm², 1.5 Hz; 20 ns, 4-mm spot; Alma Lasers; QSRL). The back of the left hand was treated with a triple combination therapy (TCT) cream with active ingredients of hydroquinone 5%, tretinoin 0.03% and dexamethasone 0.03%.

Both treatments were for 7 weeks, and all patients received sunscreen for daily use for both hands.

Pigment reduction was noted in both treatments, with QSRL treatment providing significant lightening (P = .01) compared with the TCT treatment at the end of treatment and 12 weeks after treatment.

At the end of treatment, the hand treated with the QSRL had a mean improvement of 3.5 as evaluated by the treating physician macroscopically and by the patient and a mean improvement of 3 measured by the blinded physician. For the TCT treated hand, mean macroscopical improvement was 2.4 for treating physician, 1.7 for blinded physician and 2.2 for patient.

At 12 weeks, mean macroscopical improvement with the QSRL laser was 2.9 for the treating physician, 2.8 by the blinded physician and 2.7 for the patient. The TCT-treated hand improvement was measured as 1.2 for the treating physician, 0.7 for the blinded physician and 1.1 for the patient.

While both procedures “were generally well-tolerated,” there was significantly more crusting and hyperpigmentation for the laser procedure compared with the TCT cream.

“Both QSRL and TCT were capable in reducing solar lentigines in Fitzpatrick skin type I to IV, with an acceptable side effect profile,” the researchers concluded. “The physician’s and patients’ assessment score at 12-weeks follow-up suggest that QSRL provides faster, superior and long-lasting lightening compared with TCT. Nevertheless, the latter is a reasonable alternative to laser therapy because it exhibits a safe profile with low potential for adverse events, is inexpensive and easily accessible.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.