RESUMO
BACKGROUND: Although being a benign lesion, xanthelasma palpebrarum (XP) causes cosmetic concerns. There are numerous therapeutic methods for XP with adverse events for each method. AIMS: Evaluate the safety, efficacy, and downtime of fractional CO2 laser (10 600 nm) versus 50% trichloroacetic acid (TCA) in XP therapy. PATIENTS/METHODS: Comparative interventional prospective study involved 20 adult patients with XP. Each patient received a split-face therapy where xanthelasma lesions treated with fractional CO2 laser on the one side and TCA 50% on the other side for maximum 5 sessions with 2-week intervals in between. RESULTS: Statistically significant improvement in lesion color, thickness, and size by both fractional CO2 and TCA 50%, with nonstatistically significant difference between both therapeutic modalities after treatment, although downtime, number of sessions, and patient's satisfaction were significantly better for fractional CO2 laser. CONCLUSION: Fractional CO2 laser (10 600 nm) is ideal for treatment of xanthelasma because it is safe and effective with short downtime, more patient satisfaction, less sessions, and less complications compared with chemical peeling using TCA (50%).