Efficacy and Safety of Plasma Radiofrequency Combined With Topical Tranexamic Acid for Early Post-Traumatic Scars With Hyperpigmentation: A Retrospective Study.

PURPOSE: Treatment of early post-traumatic scars with energy-based devices like plasma radiofrequency is often complicated by post-inflammatory hyperpigmentation (PIH). This study aimed to evaluate the efficacy and safety of a combination regimen of plasma radiofrequency and immediate topical application of tranexamic acid (TXA) to simultaneously address both scars and concomitant PIH.

METHODS

This retrospective study included 35 patients with early post-traumatic scars and hyperpigmentation. All patients underwent three sessions of plasma radiofrequency at 6-week intervals, each followed by immediate in-office and 7-day at-home topical application of TXA. Efficacy was evaluated using the Modified Vancouver Scar Scale (mVSS), Investigator's Global Assessment (IGA), and a patient-reported Visual Analogue Scale (VAS) for satisfaction at baseline and 6 weeks after the final session.

RESULTS

Significant improvements were observed in all patients. The mean mVSS score decreased from a baseline of 5.71 ± 1.47 to 2.66 ± 2.07 at the final follow-up (p < 0.001). According to IGA, 91.4% (32/35) of patients achieved moderate to excellent improvement. High patient satisfaction was reported on the VAS. No serious adverse events were observed; side effects were limited to transient erythema and edema.

CONCLUSION

The combination of plasma radiofrequency with immediate topical TXA application is a safe and effective strategy for treating early scars with hyperpigmentation. This dual-action approach successfully improves scar characteristics while controlling and reversing pigmentation, offering a valuable therapeutic option to optimize outcomes with energy-based devices.