Comparative study of 40% hydrogen peroxide and 50% trichloroacetic acid in the treatment of seborrheic keratoses

Background Seborrheic keratosis (SK) is a common benign skin lesion, ranging from light tan to dark brown. Common techniques for SKs removal involve cryosurgery, electrosurgery, curettage, surgical excision, and chemicals like TCA. Recently FDA has approved hydrogen peroxide 40% for the treatment of SKs. However, there is a lack of clinical studies evaluating the efficacy and complication rates of these procedures, so we have taken up the study. Aims and Objectives  To study and compare the effectiveness of 40% hydrogen peroxide (HP) and 50% trichloroacetic acid (TCA) in the treatment of seborrheic keratoses. Methods The study was conducted in our department of Dermatology at Dr. PSIMS & RF for a period of 6 months from March to August 2019. The sample size included 40 patients, and after taking informed consent, the study population was divided into two groups by systematic random sampling. One group was treated with 40% H 2 O 2 , and the other group with 50% TCA. After the first session, SKs with a Physician’s Lesion Assessment (PLA) scale higher than 0 were treated for a maximum of three sessions at two weeks interval and followed up for one month after the last session. Results After completion of all sessions, patients treated with hydrogen peroxide achieved a PLA scale of 0 (total clearance) in 45%, whereas in TCA, it was 25%, with significant p-value (<0.0001). Conclusion   Thus 40% H 2 O 2 provides a novel, standardized, easily available, and non-invasive, method to treat SKs that is convenient to patients when compared to 50% TCA.