Tranexamic Acid in Treatment of Facial Erythema
Condition: Patient With Facial Erythema
MeSH terms: Erythema; Facies
Study type: Interventional

Summary: 
      Our aim is to evaluate the efficacy of 10% topical tranexamic acid with microneedling in
      treatment of facial erythema
    

Detailed description: 
      Facial erythema is redness of the skin or mucous membranes, occurs because of cutaneous blood
      vessel dilatation and increased blood flow to the skin.it most noticeable in fair-skinned
      individuals, it may be transient erythema (flushing), persistent erythema, or perilesional
      erythema around papules and pustules .

      Flushing is a transient erythema, usually a physiological phenomenon due to strong emotion,
      exercise, heat exposure, hyperthermia, spicy food and alcohol intake. But it may be
      pathological due to pheochromocytoma, carcinoid syndrome .

      Persistent erythema is facial erythema that lasts for at least 3 months. It may be due to
      primary skin diseases such as rosacea, demodicosis, contact dermatitis, polymorphous light
      eruption, acne, drug-induced (cortisone, brimonidine), lupus erythematosus or due to systemic
      diseases as mastocytosis, dermatomyositis and hyperthyroidism Rosacea is a chronic
      inflammatory skin disease characterized by erythema, papules, pustules and telangiectasia
      affecting the central of the face, women are more often affected than men , there are several
      theories regarding the cause of rosacea, including genetic, environmental, vascular, and
      inflammatory factors, rosacea is classified into four main subtypes erythematotelangiectatic,
      papulopustular, phymatous, and ocular type

      Cutaneous lupus erythematosus (LE) is a common autoimmune disease which is limited to the
      skin, manifested with malar erythema (butterfly eruption),discoid lesions, photosensitivity .
      It is caused by a complex interplay between genetics, hormones and environmental factors,
      potential environmental triggers are ultraviolet (UV) radiation and smoking. ,
      histopathologic findings, immunofluorescence, and antinuclear antibodies will aid in making
      the diagnosis Contact dermatitis of the face can present as a result of a topical causative
      agent, and it may represent an irritant contact dermatitis, allergic contact dermatitis. A
      detailed patient history reveals the application of a topical formulation or the contact with
      a possible precipitating factor will guide the correct diagnosis .

      Acne is a multifactorial disorder of the pilosebaceous unit, characterized by
      non-inflammatory open or closed comedones and inflammatory papules, pustules, and nodules.
      may present with facial redness typically affects the areas of skin with the highest density
      of sebaceous follicles including the face, upper chest and back, A cardinal differential
      diagnosis point is the presence of comedones in acne Drug induced facial erythema due to long
      term use of a topical corticosteroid or after its abrupt discontinuation after long-term
      application. It presents with erythema, telangiectasia and papules on the areas of
      corticosteroid application, diagnosis is based on the monomorphic nature of lesions and the
      reported history of chronic application of a corticosteroid.

      Polymorphous Light Eruption (PLE) is a common photodermatosis characterized by erythematous
      papules, papulovesicular, and plaques on sun-exposed areas like the face, neck, the eruption
      appear immediately or several hours after sun exposure and the typical occurrence in spring
      and early summer .

      As not every patient with a facial erythema is the same so, the approach to the patient with
      a 'red face' includes detailed medical history , whole-body examination and additional
      laboratory tests are required to confirm the suspected diagnosis .

      Traditional options for treatment of facial erythema include the topical brimonidine tartrate
      , oxymetazoline , have high recurrence rate and Pulsed Dye Laser or Intense pulsed light
      (IPL) they are rather expensive , although these methods usually show satisfactory results,
      they are unable to meet the modern patient's need to improve his/her appearance. Therefore,
      novel and more effective treatment sought by dermatologists.

      Tranexamic acid, is an antifibrinolytic drug (synthetic lysine-like molecule) that Works by
      preventing blood clots from breaking down too quickly , it is used to prevent excessive blood
      loss from major trauma, postpartum bleeding, heavy menstruation and nose bleeds Tranexamic
      acid acting by competitively inhibits the activation of plasminogen to plasmin so, suppress
      plasmin-induced angiogenesis. It also suppressing pro-inflammatory cytokines (interleukin 6
      and tumor necrosis factor alpha). Moreover, it can restore the compromised epidermal
      permeability barrier function and thus decreasing erythema . So, we aimed to evaluate the
      efficacy of 10% topical tranexamic acid in treatment of facial erythema with microneedling.
    

Intervention name(s): Tranexamic Acid 500 MG
Intervention type(s): Drug
Intervention description(s): Each patient received treatment on both sides of the face, one side treated by micro needling with 10% topical tranexamic acid, and othert side treated by 10% topical tranexamic acid alone every 2 weeks for 3 sessions
Intervention MeSH terms: Tranexamic Acid
Allocation: Non-Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment