The Comparable Efficacy Between Tranexamic Acid Intradermal Injection and Pulsed Dye Laser for Treatment of Post-Acne Erythema: A Split-Face Therapy.

Post-acne erythema (PAE) is persistent erythema after acne vulgaris (AV) inflammatory lesions have resolved. Pulsed dye laser (PDL) is the gold standard for vascular lesions and is effective for PAE. Tranexamic acid (TA) can reduce vascular endothelial growth, angiogenesis, and inflammation by inhibiting plasminogen activity, and can be used in PAE treatment. This case report aim to compare the clinical efficacy of intradermal TA and PDL therapy using a split-face design in a 23-year-old female with moderate AV, post-inflammatory hyperpigmentation (PIH), and PEA. Dermatological examination revealed comedones, papules, pustules, nodules, hyperpigmented macules, boxcar scars, and erythematous macules overlying the post-acne atrophic scars. In addition to acne therapy, patient received intradermal TA (5 mg/mL) on the left face and PDL therapy on the right, respectively. Outcomes were assessed at day 7 and day 14. Parameters evaluated included acne lesion count, erythema index (a* value), and Dermatology Life Quality Index (DLQI). Both interventions led to a comparable result as such decreased a* value by 17.8% on the TA-treated side and 16% on the PDL-treated side. The DLQI score also improved. Both treatment modalities are effective for PAE and repeated sessions are necessary to achieve optimal results. Intradermal TA demonstrates comparable short-term efficacy to PDL in reducing PAE and may represent a safe, cost-effective alternative, particularly in resource-limited settings. Further studies with larger cohorts are needed to validate these findings.