Gheisari Mehdi, Golchin Nushin, Bazargan Afsaneh Sadeghzadeh, Gachkar Latif, Zaresharifi Shirin
Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Dermatology, Rassol Akram Medical Complex Clinical Research Development center (RCRDC), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran.
Arch Dermatol Res. 2025 Apr 1;317(1):667. doi: 10.1007/s00403-025-04215-w.
Post-acne erythema (PAE) is a common consequence of acne vulgaris, often leading to significant psychological distress and social impairment. While Intense Pulsed Light (IPL) has been proven as a non-invasive option for reducing erythema, the addition of adjunctive therapies may enhance treatment outcomes. To evaluate the effects of intradermal tranexamic acid (TXA) injections on the reduction of persistent PAE following IPL therapy in a split-face controlled trial. 33 patients aged 16 to 45 with persistent PAE were randomly assigned to receive either IPL with intradermal injection of TXA or IPL with placebo (normal saline) on opposite sides of their faces. A total of three treatment sessions were performed three weeks apart. Improvement in PAE was assessed at the follow-up session one month after the third session compared to before treatment. The response to treatment was assessed using the total physician's score of improvement based on the clinician erythema assessment scale and the patient's self-assessment based on a rating of 1 to 4. According to physicians' scores of improvement and patients' self-assessment of TXA injection, improvement in erythema was observed in most of the patients. Nevertheless, these results were not statistically significant. In addition, IPL treatment (on the control side) effectively improved PAE based on physicians' scores of improvement and patients' self-assessments, still, these results were statistically significant only in the physicians' scores of improvements. Furthermore, 53% of patients did not report adverse reactions on the intervention side. The most commonly mentioned side effect was erythema on the injection side in 27.3% of patients, which was resolved within 24 h in all cases. This study highlights the complexities of treating persistent PAE. While most patients reported mild to moderate improvement with intradermal TXA, the combination of intradermal TXA and IPL did not show significant improvement over IPL treatment. Adverse effects were minimal, with injection site erythema being the most common. These findings warrant further investigation into optimizing treatment protocols for PAE management.
痤疮后红斑（PAE）是寻常痤疮的常见后果，常导致严重的心理困扰和社交障碍。虽然强脉冲光（IPL）已被证明是一种减少红斑的非侵入性选择，但添加辅助治疗可能会提高治疗效果。在一项半脸对照试验中，评估皮内注射氨甲环酸（TXA）对IPL治疗后持续性PAE减轻的效果。33名年龄在16至45岁之间患有持续性PAE的患者被随机分配，在其脸部的对侧分别接受IPL联合皮内注射TXA或IPL联合安慰剂（生理盐水）治疗。总共进行了三次治疗，每次间隔三周。在第三次治疗后一个月的随访中，与治疗前相比，评估PAE的改善情况。根据临床医生红斑评估量表的医生总体改善评分以及患者基于1至4级评分的自我评估来评估治疗反应。根据医生对TXA注射的改善评分和患者的自我评估，大多数患者的红斑有所改善。然而，这些结果在统计学上并不显著。此外，基于医生的改善评分和患者的自我评估，IPL治疗（在对照侧）有效地改善了PAE，但这些结果仅在医生的改善评分中具有统计学意义。此外，53%的患者在干预侧未报告不良反应。最常提到的副作用是27.3%的患者注射侧出现红斑，所有病例均在24小时内消退。本研究突出了治疗持续性PAE的复杂性。虽然大多数患者报告皮内注射TXA后有轻度至中度改善，但皮内注射TXA与IPL联合使用并未显示出比IPL治疗有显著改善。不良反应极少，注射部位红斑最为常见。这些发现值得进一步研究以优化PAE管理的治疗方案。
