Tranexamic acid versus fractional carbon dioxide laser in post‐acne hyperpigmentation
Shereen O. Tawfic, Rania Abdel Hay, Hadeel Salim, Maha Fathy Elmasry
Abstract
Abstract Post‐acne hyperpigmentation is a common undesirable sequela of acne vulgaris that causes distress for many patients. This study's objective was to compare the efficacy of both low‐power/low‐density fractional carbon dioxide (CO 2 ) laser and tranexamic acid (TXA) microinjection on post‐acne hyperpigmentation. Twenty‐five post‐acne hyperpigmentation patients (resistant to regular treatment for more than 6 months) were enrolled in this randomized split‐face study. One side of the face was randomly assigned to low‐power fractional CO 2 laser every 4 weeks, and the other side was assigned to TXA intradermal‐microinjection every 2 weeks for 3 months. Efficacy was evaluated using digital photography, dermoscopy, post‐acne hyperpigmentation index (PAHPI), melanin index (MI), and erythema index (EI) at baseline and 4 weeks after the last session. Both fractional CO 2 laser and TXA microinjection treatment sides showed a significant reduction in the PAHPI and MI ( p < 0.001). There was statistically significant difference with better percentage of improvement regarding total dermoscopic score on the fractional CO 2 laser side than the TXA microinjections side ( p < 0.009). Both fractional CO 2 laser and TXA microinjection are effective and safe treatment options for post‐acne hyperpigmentation with potential superiority of fractional CO 2 laser. We also believe that dermoscopy could be helpful tool for assessment of pigmentation depth in patients on treatment by analyzing the color pattern. ClinicalTrials.govID: NCT03765021.