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.