Xanthelasma, characterized by yellowish cholesterol deposits around the eyelids, often necessitates therapeutic interventions. Ablative CO2 laser treatment is a common approach, yet associated complications warrant exploration of alternative therapies. Recently, intradermal heparin sodium injections emerged as a potential treatment. A study compares the efficacy of CO2 laser versus heparin sodium injections in managing xanthelasma lesions. This study was published in the journal Photodermatology, Photoimmunology and Photomedicine by Yomna M. and colleagues.

CO2 Laser vs. Heparin Sodium:
A pilot study involving 30 xanthelasma patients divided into two groups:
Group A underwent CO2 laser ablation (2 sessions every 4 weeks).
Group B received intradermal heparin sodium injections (10 sessions every week).
Therapeutic Efficacy:
Both interventions exhibited significant reduction in xanthelasma lesions.
CO2 laser treatment was notably more effective than intradermal heparin sodium overall.
Treatment Specifics:
Intradermal heparin sodium demonstrated comparable effectiveness to CO2 laser in early-stage (grade I and II) xanthelasma, particularly within <2 years duration.
Notably, heparin sodium showed a lower incidence of post-therapy side effects compared to CO2 laser.
Clinical Implications:
Heparin sodium injections present as a safe and cost-effective therapeutic technique for early-stage mild xanthelasma (grade I and II).
Additionally, it might serve as a pre-operative management for advanced xanthelasma (grade III and IV), aiding in lesion reduction before CO2 laser ablation.
The study highlights the comparative efficacy of CO2 laser and intradermal heparin sodium injections in managing xanthelasma. While CO2 laser remains more effective overall, heparin sodium emerges as a promising alternative, particularly in treating early-stage xanthelasma with fewer side effects. This research offers valuable insights into diversifying therapeutic options for xanthelasma management.
Reference:
Neinaa, Y. M. E.-H., Awara, B. S. E.-S., Shalaby, O. E.-S., & Abd El-Naby, N. M. Clinical and dermoscopic assessment of ablative carbon dioxide laser versus intradermal heparin sodium in xanthelasma. Photodermatology, Photoimmunology & Photomedicine,2023;39(6):648–656. https://doi.org/10.1111/phpp.12915