Topical 10% Tranexamic Acid in Topical Steroid-Damaged Faces: A Non-Randomised Interventional Study

Topical Steroid Damaged/Dependent Face (TSDF) is described as 'the semi-permanent or permanent damage to the skin of the face precipitated by the irrational, indiscriminate, unsupervised, or prolonged use of TCs resulting in a plethora of cutaneous signs and symptoms and psychological dependence on the drug'. Its management is difficult due to the unavailability of a universally accepted treatment regimen, as well as a high rate of rebound after stopping therapy.

To study the efficacy and safety of the application of 10% tranexamic acid solution in Topical Steroid Damaged/Dependent Faces.

In this non-randomised interventional study, 15 cases with TSDF were treated with topical 10% tranexamic acid solution applied once daily for 8 weeks and followed up every 4 weeks up to 12 weeks. Erythema, the hallmark of TSDF, was graded based on the Clinician's Erythema Assessment (CEA) scale, and improvement in this score was recorded at every follow-up visit along with clinical photographs.

Erythema, photosensitivity and telangiectasia were present in all our subjects, followed by pigmentary abnormalities, acneiform eruptions, hypertrichosis and atrophy. Based on the reduction in CEA, we recorded a statistically significant improvement in erythema at week 4, and complete resolution of the same in 100% of our subjects by week 8.

Topical 10% tranexamic acid solution is a novel, promising, safe and efficacious modality in the treatment of TSDF.