Photo Credit: RossHelen

The following is a summary of “Treatment of Solar Lentigines: A Systematic Review of Clinical Trials,” published in the March 2025 issue of Journal of Cosmetic Dermatology by Mardani et al. 

Solar lentigines developed from prolonged UV exposure and served as early indicators of photoaging, significantly impacting individuals.  

Researchers conducted a retrospective study to evaluate the efficacy, safety, and tolerability of treatments for solar lentigines due to the lack of conclusive evidence on optimal therapy options.  

They searched PubMed/Medline, EMBASE, Cochrane Library, and clinicaltrials.gov to identify clinical trials published until December 7, 2023. Studies were included if they involved individuals diagnosed with solar lentigines, utilized clinical trial methodologies, and reported clinical outcomes. The Cochrane tool was used to assess study quality.  

The results showed that 41 clinical trials included 3,234 individuals aged 24–92 years. The most effective topical treatment was mequinol 2% with tretinoin 0.01%, showing efficacy rates of 52.6% to over 80%, especially for facial lesions. Laser therapies demonstrated varied success: pulsed dye laser (27%–57%), intense pulsed light (74.6%–90%), Q-switched laser (36.36%–76.6%), picosecond laser (67.9%–93.02%), and fractional CO₂ laser (8%–23%). Cryotherapy achieved 37%–71.4% success, while trichloroacetic acid chemical peels showed 12%–46%. Most adverse effects were mild, with topical agents causing local irritation and therapies inducing mild pain. Pulsed dye and intense pulsed light lasers had fewer cases of post-inflammatory hyperpigmentation, while cryotherapy resulted in more severe side effects.  

Investigators concluded that laser therapy appeared more effective than other modalities with acceptable safety and that combining it with specific topical agents that might further improve outcomes and reduce post-inflammatory hyperpigmentation. 

Source: onlinelibrary.wiley.com/doi/full/10.1111/jocd.70133