[5 min read] Hydrogen peroxide to treat seborrhoeic keratoses

Seborrhoeic keratoses affect all racial groups and commonly appear after the age of 40. Approved topical treatments for the skin condition are an unmet need, so a study in the US evaluated the safety and efficacy of 40% hydrogen peroxide topical solution (HP40) versus vehicle for the treatment of seborrhoeic keratoses.

A total of 937 patients with four seborrhoeic keratoses each (with one or more lesion each on the face and on the trunk and/or an extremity) were randomised 1:1 to HP40 or vehicle. At each visit, seborrhoeic keratoses were graded using the Physician’s Lesion Assessment (PLA) scale (0, clear; 1, nearly clear; 2, ≤1 mm thick; and 3, >1 mm thick).

After one treatment, SKs with a PLA score higher than 0 were re-treated three weeks later.

At day 106, significantly more patients treated with HP40 than with vehicle achieved a PLA score of 0 on all four seborrhoeic keratoses (study 1, 4% vs 0%; study 2, 8% vs 0%) and on three of four seborrhoeic keratoses (study 1, 13% vs 0%; study 2, 23% vs 0%).

A higher mean per-patient percentage of seborrhoeic keratoses were clear (study 1, 25% vs 2%; study 2, 34% vs 1%) and clear or nearly clear (study 1, 47% vs 10%; study 2, 54% vs 5%) with HP40 than with vehicle.

Currently, cryotherapy is a common, effective treatment for seborrhoeic keratoses, but it is painful, may have prolonged healing and will often leave scarring. When compared to cryotherapy, the results of this study seem less effective, with complete clearance ranging from 25% to 54%. However, most local skin reactions were mild and had resolved by the end of the study, with scarring, hypopigmentation and hyperpigmentation occurring in <1%, 3% and 7.8%, respectively, which is less than occurs with cryotherapy.

The study was limited in that the optimal number of treatment sessions was not evaluated. Only two treatments were given, but three or four treatments may achieve better efficacy.

Researchers concluded that application of hydrogen peroxide topical solution was well tolerated and effective in the removal of seborrhoeic keratoses.

This may become useful as an over-the-counter product, like wart paints, that can be used directly by the patient.

Read more recent research.

Source: Safety and efficacy of hydrogen peroxide topical solution, 40% (w/w), in patients with seborrheic keratoses: Results from 2 identical, randomized, double-blind, placebo-controlled, phase 3 studies (A-101-SEBK-301/302). Baumann, Leslie S. et al. Journal of the American Academy of Dermatology, Volume 79, Issue 5, 869 – 877

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