Which medications are used in the treatment of lentigo?

Updated: Feb 23, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Noninvasive topical creams are also used. After several months of application, tretinoin cream and hydroquinone cream can lighten lentigines.

The efficacy and safety of cryotherapy and trichloroacetic acid (TCA) were compared for the treatment of solar lentigo. [36] Cryotherapy was more effective than TCA 33% solution in the treatment of solar lentigines of the back of the hands, particularly in lighter-complexioned individuals. For darker-complexioned people, TCA 33% may be preferred, although postinflammatory hyperpigmentation remains a risk for both modalities.

A triple combination cream with fluocinolone acetonide 0.01%, hydroquinone 4%, and tretinoin 0.05% as adjuvant to cryotherapy for solar lentigines on the dorsal hands was found to be effective. [37]

The effect of a bleaching solution containing 2% mequinol (4-hydroxyanisole, 4HA) and 0.01% tretinoin (Solagé) applied twice daily for 3 months on solar lentigines present on the back of one hand demonstrated a significant lightening effect after 2 months of treatment and was maintained at least 2 months after stopping treatment. [38]

Skin-lightening products commercially available target natural melanin production, many as competitive inhibitors of tyrosinase. [39]  Phalaenopsis orchid extract may be useful as a novel treatment of solar lentigines. [40]  Favorable efficacy and safety were observed with Melasolv (3,4,5-trimethoxy cinnamate thymol ester, TCTE) in Southeast Asian women. [41]

A weak but significant whitening effect on solar lentigos was documented using L-ascorbate-2-phosphate trisodium salt in Japanese women. [42]

Imiquimod 3.75% cream has been suggested as possibly efficacious. [43]

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