From the Guidelines
Solar lentigo can be effectively treated with topical retinoids, such as adapalene 0.3% or tretinoin 0.01% and 0.05%, which have been shown to lend additional benefit with respect to improvement in lentigines and reduced wrinkles 1. The treatment of solar lentigo, also known as actinic lentigo, involves a range of options, including topical treatments and in-office procedures.
- For mild cases, over-the-counter topical treatments containing hydroquinone (2%), retinoids, or alpha hydroxy acids can be used.
- Prescription-strength options include higher concentration hydroquinone (4%), tretinoin cream (0.025-0.1%), or combination products like Tri-Luma (containing fluocinolone, hydroquinone, and tretinoin).
- In-office procedures such as cryotherapy, laser therapy, chemical peels, or microdermabrasion can also be effective in removing solar lentigines. However, according to the British Association of Dermatologists' guidelines for the care of patients with actinic keratosis 2017, topical retinoids are a recommended treatment option for solar lentigo, with a strength of recommendation B and level of evidence 1+ 1. It is also important to note that prevention is key, and daily application of broad-spectrum sunscreen (SPF 30+) can help prevent new spots from forming and existing ones from darkening. The British Association of Dermatologists' guidelines also suggest that topical retinoids may be used in a sustained manner, rather than as a limited course of treatment, to achieve optimal results 1. Overall, the choice of treatment for solar lentigo will depend on the individual patient's needs and preferences, and should be guided by the latest evidence-based recommendations.
From the Research
Treatment Options for Solar Lentigo
The treatment for solar lentigo, also known as actinic lentigo, can vary depending on the severity and location of the lesions. Some of the treatment options include:
- Topical creams and solutions, such as 2% mequinol/0.01% tretinoin solution 2, 3, 4
- Chemical peels 3
- Cryotherapy 3
- Laser therapy, including Q-switched ruby laser 5, 6
- Intense Pulsed Light (IPL) therapy 3
- Triple combination skin-lightening cream, containing hydroquinone, tretinoin, and dexamethasone 6
Efficacy of Treatment Options
Studies have shown that:
- The combination of 2% mequinol and 0.01% tretinoin is effective in improving the appearance of solar lentigines and related hyperpigmented lesions 2, 3, 4
- Q-switched ruby laser therapy is a safe and effective treatment option for removing solar lentigines, providing significant lightening compared to triple combination therapy 6
- Chemical peels and cryotherapy can also be effective in treating solar lentigines, although they may have more variable results 3
- Triple combination skin-lightening cream can be effective in reducing solar lentigines, but may have a slower and less pronounced effect compared to laser therapy 6
Safety and Tolerability
Most treatment options for solar lentigo are generally well-tolerated, with mild to moderate side effects, such as: