Adjunctive treatment for acne vulgaris by tranexamic acid

J Cosmet Dermatol. 2022 Oct;21(10):4515-4522. doi: 10.1111/jocd.14972. Epub 2022 May 10.


Background: Acne is a chronic, inflammatory skin disorder of pilosebaceous units. Tranexamic acid (TXA) acts as a plasmin inhibitor to reduce blood loss and is also used to treat rosacea due to its anti-inflammatory effects. Some parts of the pathogenesis of rosacea are similar to inflammatory acne.

Objectives: The study aimed to evaluate the efficacy of 10% TXA serum in treating acne and its adverse effects.

Methods: A randomized, double-blind, placebo-controlled, split-face study was performed on 18 mild-to-moderate acne patients. Patients applied 10% TXA serum on one side of the face and placebo on another side twice daily for 8 weeks. Acne lesion counts and adverse effects were evaluated every 2 weeks.

Results: Significant differences in total inflammatory acne counts were observed between TXA and placebo since Week 4 (p = 0.008). TXA mainly reduced papules and pustules, as papule counts significantly decreased since the 8th week (p = 0.046) and pustule counts significantly reduced since Week 8 (p = 0.033). Moreover, physicians also found that TXA serum reduced the redness of the skin, corresponding with the imaging from VISIA® Skin Analysis. The anti-inflammatory effect of TXA resulted in less PIE and PIH. Adverse effects, including erythema and scaling, were treated by applying any moisturizing cream.

Conclusion: Topical 10% TXA can reduce inflammatory acne effectively. Adverse effects were minor and treat easily.

Keywords: acne vulgaris; adjunctive therapy; anti-inflammatory effect; topical serum; tranexamic acid.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acne Vulgaris* / drug therapy
  • Anti-Inflammatory Agents / therapeutic use
  • Double-Blind Method
  • Humans
  • Rosacea* / drug therapy
  • Tranexamic Acid* / adverse effects
  • Treatment Outcome


  • Tranexamic Acid
  • Anti-Inflammatory Agents