摘要

Objectives: To evaluate the clinical efficacy and safety of Zhuang medicine medicated thread moxibustion compared to trichloroacetic acid (TCA) peeling in the treatment of xanthelasma. This study also highlights its applicability in patients seeking minimally invasive alternatives with fewer adverse effects and higher cosmetic satisfaction. Introduction: Xanthelasma palpebrarum often causes cosmetic concerns. While TCA peeling is widely used, it carries risks of scarring and pigmentation. Zhuang medicine medicated thread moxibustion, a traditional thermal and herbal therapy, has shown promise in case series with excellent outcomes and no recurrence. This study investigates its value versus TCA. Materials / method: 61 patients were randomly assigned to either TCA peeling or medicated thread moxibustion, performed in 3 sessions over 20 days. Lesion width, adverse events, and lesion clearance were recorded. Results were compared with data from a published case series involving complete resolution in all patients without recurrence or complications. Results: Both groups achieved similar efficacy for small lesions (≤1 cm). For larger lesions, moxibustion provided comparable clearance with significantly fewer side effects. Results from a supporting case series confirmed 100% lesion resolution in three female patients, with only mild edema resolving within 24 hours and no recurrence at 3 months. Conclusion: Medicated thread moxibustion is a safe and effective alternative to TCA peeling for xanthelasma. It offers high lesion clearance, minimal recovery time, and reduced adverse reactions, including no scarring. These findings support its integration into modern aesthetic dermatology, especially for Asian skin or patients concerned with post-treatment dyspigmentation.