A split face study comparing intralesional tranexamic acid versus 1064 nm long pulsed Nd: YAG laser for acne vulgaris treatment

Acne is among most prevalent skin conditions that adversely impacts patients’ quality of life and self-confidence. Conventional treatment methods face issues with high recurrence rates and unwanted side effects, prompting the need to explore new acceptable treatment options. Comparing the safety and clinical efficacy of intralesional tranexamic acid (TXA) versus 1064 nm long pulsed Nd:YAG laser in the treatment of facial inflammatory acne vulgaris. 30 patients with facial acne vulgaris were involved in a prospective randomized split-face comparative study. Each patient was treated with long-pulsed Nd: YAG laser on one side, and intralesional TXA on the other side at 2-week interval for 4 sessions. Cases were assessed through Investigator Global Assessment of acne (IGA) scale, lesions counting, and erythema score at baseline, after end of treatment, and after follow-up for 3 months. A statistically significant reduction in IGA, lesions count, and erythema score was found in both treated sides (p-value < 0.001). Improvement of IGA and non-inflammatory lesions count was better in laser side more than TXA side after end of treatment and follow-up (p-value < 0.05). Improvement of inflammatory lesions count was non-significant in both sides after end of treatment, while after follow-up it was better on laser side. Improvement of erythema score was non-significant between both therapy modalities after end of treatment and follow-up. 1064 nm long-pulsed Nd: YAG laser and intralesional TXA are effective, and safe treatment modalities for acne. However, Nd-YAG laser has prolonged therapeutic effect over intralesional TXA so, TXA can be considered a promising lunch-time procedure enhancing the outcome.