Hydrogen Peroxide Topical Solution, 40% (w/w) for the Treatment of Seborrheic Keratoses

A Review

Emily C. Murphy, BS; Adam J. Friedman, MD


Skin Therapy Letter. 2020;25(1):1-4. 

In This Article

Patient Selection

When choosing a strategy for SK removal, it is important to consider the SK's location as well as the patient's skin type and treatment expectations. Based on the finding that HP40 is most efficacious for SKs on the face compared to the trunk and extremities, HP40 may be a good therapy to discuss with patients seeking treatment for SKs in cosmetically-sensitive areas like the face. While additional clinical studies are needed to explore this assertion, HP40 may destroy fewer melanocytes than cryotherapy, meaning that HP40 may be a potentially beneficial therapy for patients with dark skin who are susceptible to pigmentary changes with cryotherapy.[7] On the contrary, because of the high cost of HP40 and need for repeat treatments, it is likely less useful for symptomatic SKs in non-cosmetically sensitive locations where patients desire rapid relief without as much concern about the cosmetic outcomes.

In terms of pregnancy and lactation risk, topical H2O2 is not systemically absorbed. Therefore, application of HP40 during pregnancy or while lactating should not result in exposure of the fetus or breastfeeding infant.[24]