New Treatment Available for Hyperpigmentation and Visible Blood Vessels
Acne can be incredibly challenging for people when there is a change in their skin’s appearance.
This is especially true for people with hyperpigmentation and visible blood vessels under the skin.
These acne symptoms can affect a person’s self-esteem and the way they perceive themselves, consequently affecting their overall quality of life.
Traditionally, there has not been a treatment to combat the residual effects of acne.
However, a recent study published in the Clinical Cosmetic and Investigational Dermatology journal has discovered that Tranexamic Acid (TXA) has a promising application for dermatology.
TXA has been used in general medicine to control bleeding in trauma, surgical procedures, as well as to prevent bleeding episodes in patients with haemophilia.
However, recent research has found TXA to have a positive effect for hyperpigmentation and visible blood disorders for acne patients.
What is hyperpigmentation?
Hyperpigmentation is a condition where patches of skin appear darker than the surrounding skin.
It occurs when there is an excess production of melanin—the pigment that gives skin its colour.
Hyperpigmentation is very common for people of colour, as dark skin tones already have a higher melanin content.
What is TXA?
TXA is a well-known drug that promotes the process and speed of blood clotting.
Traditionally, TXA has been used by doctors to control bleeding in trauma, surgical procedures and dental interventions.
Although TXA can quickly clot blood, it also can reduce skin pigment production, decrease inflammation and prevent new blood vessels forming.
The drug can be used as an oral and topical treatment, as well as intradermal injections.
Intradermal injections are microneedling-assisted TXA delivery just below the epidermis (top) layer of the skin.
The new research has revealed its promising applications in dermatology.
What the research involved
The researchers reviewed clinical studies and trials that examined TXA’s effectiveness in treating dermatological skin conditions, such as post-inflammatory hyperpigmentation.
The research also examined other pigmentation disorders, such as:
- Reihl’s Melanosis: An uncommon form of pigmented dermatitis characterised by hyperpigmentation, mostly found on the face and neck.
- Rosacea: A chronic condition causing sensitive skin, redness, inflammation and sometimes papules (red bumps) or pustules (pus-filled spots), often appearing like acne.
- Post-acne redness: A common skin condition where red or pink spots remain after acne breakouts.
Oral, topical and intradermal injection forms of TXA were reviewed by the researcher.
Research Findings
The study concluded that TXA was effective for treating hyperpigmentation and visible blood vessels.
It found that both oral and topical TXA reduced skin discolouration after inflammation, such as that seen with acne laser treatments.
The Benefits of TXA for Acne
The study suggested that TXA possesses multiple properties that are beneficial for your skin and potentially beneficial in treating acne.
These benefits included:
- Anti-Melanogenesis: The drug can stop the production of melanin, which helps to reduce hyperpigmentation.
- Anti-Inflammatory Effects: The drug can calm inflammation and potentially address redness associated with acne. This is particularly valuable as inflammation not only drives the development of acne lesions but also plays a significant role in the formation of acne scarring.
- Anti-Angiogenesis: The TXA reduces the formation of new blood vessels, potentially decreasing persistent redness.
- Skin-Barrier Support: TXA promotes a healthier skin barrier, which aids in overall skin repair. A poor epidermal barrier may contribute to underlying skin inflammation.
Mechanisms of TXA: Why it Works?
The effectiveness of TXA lies in it its many approaches to battling acne on the skin.
These mechanisms include:
- Inhibition of Plasminogen Activation: TXA prevents the conversion of plasminogen to plasmin, which not only reduces melanin production but also stops inflammation.
- Reduces Pro-Inflammatory Mediators: By suppressing inflammatory pathways, TXA helps to control redness and swelling of pimples.
- Regulation of Angiogenesis: TXA reduces the number of new blood vessels, minimising the persistent skin redness and improving skin tone.
- Barrier Repair: By strengthening the skin barrier, TXA enhances the skin’s strength against environmental and inflammatory triggers.
Treating Other Pigmentation Disorders
Riehl’s Melanosis is a stubborn pigmentation disorder, and while rare, it is challenging to treat.
The recommended treatment plan involves a combination of low-fluence lasers, Hydroquinone, and oral TXA.
TXA is comparable to Azelaic Acid and Hydroquinone but with the added benefit of having a better safety profile—meaning less likelihood of severe side effects.
Hydroquinone is a topical treatment used to lighten areas that have darkened from hyperpigmentation.
It inhibits melanin synthesis.
TXA (both oral and topical applications) was also found to reduce redness and visible blood vessels in people with Rosacea.
Participants from the study who presented with post-acne redness benefited from TXA—a topical injectable that helped to reduce redness.
A Potential Role in Acne Management
TXA offers a unique approach to acne care by targeting both active inflammation and lasting effects such as redness and hyperpigmentation.
The change in the skin’s appearance can be a challenge for many people, but TXA could now be the solution to enhance the outcome for patients dealing with low self-esteem.
Like all treatments, it is best to talk to your dermatologist to determine the best approach for your needs and skin.
The Need for Further Research
While early results are promising, more research is needed to determine the best form of TXA—oral, topical or intradermal injections—as well as the ideal treatment duration and frequency.
More importantly, research will need to assess the safety and efficacy of long-term TXA use.
It is promising that the benefits of TXA could be amplified when paired with other acne treatments.
For instance, pairing TXA with topical retinoids could enhance anti-inflammatory and skin-renewing effects.
Incorporating TXA into a combination treatment strategy could also provide a more holistic care for people experiencing acne—addressing not just current acne lesions but also the aftermath of acne.
Leading dermatologists are increasingly exploring such a combination to achieve the best results.
Conclusion
This new form of treating acne with blood-clot medication, TXA, is a safe and effective treatment for hyperpigmentation and visible blood vessels.
This is especially true for patients who cannot tolerate traditional treatments such as laser therapy or Hydroquinone.
TXA’s ability to address the cause and symptoms of acne is a game-changing approach to dermatological treatment.
As we await more research, TXA offers hope for those wanting to combat the lingering marks of acne while preventing new breakouts.
Reference: Chen T, Xue J, Wang Q. Tranexamic acid for the treatment of hyperpigmentation and telangiectatic disorders other than melasma: An update. Clinical, Cosmetic and Investigational Dermatology. 2024 December 31:2151-63.
