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

Abstract Background: 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. Aim: To study the efficacy and safety of the application of 10% tranexamic acid solution in Topical Steroid Damaged/Dependent Faces. Methods: 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. Results: 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. Conclusions: Topical 10% tranexamic acid solution is a novel, promising, safe and efficacious modality in the treatment of TSDF.