Tranexamic Acid Injections May Be Efficacious in Acne Vulgaris

Tranexamic acid injections in patients with post-acne vulgaris erythema may be effective in reducing redness.

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According to a recent study,¹ researchers said the use of the injections as a form of mesotherapy may harbor positive results. They sought to determine the efficacy and safety of tranexamic acid, specifically in an injection form, in treating lingering erythema from patients with improved acne.

The trial, which was split-face in nature, was conducted from September 2019 to April 2021 at a singular dermatology clinic. 17 patients with persistent post-acne erythema presented for participation in the trial. However, of these, 15 patients completed the study in its entirety, with 1 patient exiting due to treatment intolerance and 1 patient who did not present for follow-up.

Prospective participants with coagulopathy disorders, cancers, drug allergies, pregnancy, and lactation, were excluded from participation. Additionally, patients using medications that have known reactions or may lead to reactions with tranexamic acid, were also excluded, as were patients who were actively being treated with oral or topical tretinoid drugs.

Before beginning treatment, all participants were photographed using a Visioface device. During the study, participants were treated with the injections during 2 separate sessions spaced 2 weeks apart from one another. Afterwards, they were asked to return 1 month post-final session to again be photographed using the Visioface device.

Researchers deemed the left side of participants’ faces the designated control side, while the right side of their faces were used for treatments.

When participants presented to their treatment sessions, researchers applied a topical lidocaine and pirlocaine combination 30 minutes prior to delivering the injection. 5 mg tranexamic acid ampules were then injected intra-dermally in areas experiencing post-acne erythema and spaced 1 cm apart. The total amount of tranexamic acid injection (in mL) varied by patient, but ranged from 2 mL to 5 mL.

Following the injection, researchers cleansed the treatment area with saline and applied a 0.25% zinc oxide ointment. All participants were instructed to refrain from washing their faces until the end of the day of their treatment. Additionally, they were asked to apply sunscreen for 3 to 4 consistent days after treatment for skin protection.

As a result of the treatment, researchers noted significant differences between the treatment and control sides of participants’ faces in terms of erythematic lesion count, area, and area percent before and after the study period.

“In this study, for the first time, the effects of TA [tranexamic acid] as mesotherapy on erythematous lesions after acne have been studied because of anti-inflammatory, anti-redness, and anti-angiogenesis of it,” study authors wrote. “The results showed that according to the documentation and video evaluations of patients before and after the intervention, a significant improvement of acne erythema can be seen in this method.”

Reference

1. Sadeghzadeh Bazargan A, Gheisari M, Taheri A, Mirahmadi S, Abouie A, Ziaeifar E. Evaluating the effect of tranexamic acid as mesotherapy on persistent post-acne erythema: A before and after study. Journ Cosm Dermatol. April 2023. doi:https://doi.org/10.1111/jocd.15776