Topical Hydrogen Peroxide May Be Most Effective for Facial Seborrheic Keratoses

A new study published in the Journal of Drugs in Dermatology reported that 40% hydrogen peroxide (HP40) therapy may clear raised seborrheic keratoses (SKs) better on the face than on the body. Stacy and associates conducted a study to understand the relationship between Seborrheic keratosis location and clearance with up to 2 treatments of 40% (w/w) hydrogen peroxide topical solution (HP40).

The researchers performed a sub-analysis of data pooled from two randomized, double-blind, vehicle (VEH)-controlled clinical trials, including 937 patients, each with 4 targets SKs with at least 1 on the face and 1 on the trunk or extremities.

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Treatment response was defined as 0 or 1 on a 4-point Physician’s Lesion Assessment (PLA) scale (0=clear; 1=near-clear) after up to 2 applications, 3 weeks apart, and was assessed by SK location (face, trunk, and extremity).

The investigators found that the treatment response was superior with HP40 treatment compared with the vehicle arm in all SKs locations: 65% vs 10% on the face; 46% vs 5% on the trunk; and, 38% vs 9% on the extremities.

Facial SKs were more likely to be clear or almost clear following a single HP40 treatment at 43% compared with SKs on the trunk (31%) or on the extremities (14%).

Most common immediate reactions with HP40 were erythema, stinging, and edema, which resolved to none or mostly mild within a week. Delayed reactions such as dyspigmentation and scarring occurred at low rates and were least reported for the facial SKs.

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“ Dyspigmentation rates were lowest among SKs treated on the face. Anatomic location of SK was a predictor of both treatment response and risk of dyspigmentation with HP40 application, ”write the authors.

The authors concluded that SK clearance with HP40 was highest among SKs on the face and lowest among SKs on the extremities.