A split face comparative study using a novel triple combination therapy for the treatment of persistent post acne erythema

Abstract

Persistent post acne erythema (PAE) is common cosmetically unacceptable and challenging sequelae of acne lesions. Tranexamic acid (TXA) is an antifibrinolytic agent that shows a positive effect on wound healing in several studies, and it showed benefits in treating skin diseases like melasma, rosacea erythema and ultraviolet induced pigmentations. Oxymetazoline (OXZ) is a synthetic, highly selective agonist for alpha 1A‐adrenoceptor. It is a potent vasoconstrictor. OXZ hydrochloride 1% cream was approved by the FDA in January 2017 as a topical treatment for persistent facial erythema in rosacea patients. Brimonidine tartrate (BMT) is highly selective α2 adrenergic receptor agonist, results in direct, potent vasoconstriction of small arterioles and veins. In 2013, brimonidine 0.33% gel was the first topical therapy to be FDA approved for the treatment of persistent facial erythema from rosacea. To evaluate the efficacy and safety of topical triple combination (TXA 5% + OXZ 1.5% + BMT 0.33%) in the treatment of PAE planned as split face comparative study. This study was conducted on 40 patients diagnosed with persistent PAE for at least 3 months, the right side of the face was treated with topical triple combination in liposomal base and was compared to the left side to which topical lipocream (placebo) was applied as a control. Our treatment plan lasted for 3 months. According to the investigator's global assessment of photographs and computerized analysis of erythema using image analysis software, topical triple combination applied on the right side of face was significantly effective in diminishing PAE when compared to topical placebo left side. Topical triple combination is a safe and cost‐effective treatment for PAE.

Efficacy and Safety of Detachable Microneedle Patch Containing Triamcinolone Acetonide in the Treatment of Inflammatory Acne

“…Interestingly, all DMN treatments can signi cantly reduce post-acne erythema when compared to no treatment. Post-acne erythema is a common sequelae of acne after in ammatory lesions, causing psychological distress and frustration in many patients [18][19][20]. In this study, we observed the positive effect of DMN on post-acne erythema.…”

The role of the topical nasal decongestant oxymetazoline as a novel therapeutic option for post‐acne erythema: A split‐face, double‐blind, randomized, placebo‐controlled trial

“…PAE occurs from the release of inflammatory cytokines, such as interleukin (IL)-6 and tumor necrosis factor (TNF)α, that remain after resolution of inflammatory acne lesions, resulting in the dilation of microvascular structures and aggregations of erythrocytes in the capillaries. 1,2,32 Oxymetazoline hydrochloride (the molecular mass, 296.84) 33 is a synthetic sympathomimetic agonist with a high affinity for α 1A -adrenergic receptors and a partial affinity for α 2A -adrenergic receptors. Activation of these postsynaptic adrenoceptors promotes superficial cutaneous vasoconstriction.…”

Efficacy and safety of topical brimonidine in dermatology: A review article

“…The acne group had a more significant improvement than the rosacea group based on CEA at the end of each period. This difference may be due to the mean age, which was less in the acne group relative to the rosacea group (24.05 vs. 44.5, P = 0.001), or due to the neurovascular system stability in acne patients 11 …”

“…This difference may be due to the mean age, which was less in the acne group relative to the rosacea group (24.05 vs. 44.5, P = 0.001), or due to the neurovascular system stability in acne patients. 11 To evaluate the anesthetic effect of brimonidine gel on laserinduced pain and erythema, 15 patients received a combination of brimonidine and lidocaine on half of the face and lidocaine alone on the other half before the laser. The half of the face where the combined method was used showed a better improvement in terms of erythema (based on CEA and erythema index) than the opposite side immediately after the laser and up to 1 h later.…”