Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Dermatology

Backgroud: Facial freckles are a cosmetic concern, particularly to young females. Treatment of freckles is a challenge. Different therapeutic modalities have been tried, with variable response rates and limitations.Objectives: To assess and compare the efficacy and safety of Tranexamic acid(TXA) intradermal microinjection versus QsNdYag laser (532 nm) in treatment of freckles Methods: A randomized comparative split face study included a total of thirty patients with bilateral, symmetrical freckles. One side of face was treated with the QsNd:YAG laser at a wavelength of 532nm ,other side of the face was assigned to TXA intradermal microinjection using (Kapron)®.The sessions of TXA was every 2 weeks for 2 months while QSNd:YAG (KTP) laser (Fotona Qx Max) was 1-2 sessions and follow up after 2 months. Assessment was done using the pigmentation area and severity index (PSI) score, melanin index (MI) and erythema index (EI), photography, patient satisfaction and blinded physician assessment, it was done at baseline then 1 week after the last treatment session then 2 month after last treatment session. Results: A significant difference was found between both sides regarding % change of pigmentation area and severity score (PSI) and melanin index (MI) after treatment and during follow up with laser showed better results (p=0.001). PSI decreased after treatment by 66.5% and 15.4% ( laser and TXA sides respectively), further drop after follow up, by 69.4% with laser and 26.1% with TXA. MI improved from 2.4% after TXA injections to 6.5% after follow up, and by 3.7% after KTP laser to 7.7% after follow up. Conclusion: QS-KTP laser effectively targets pigmentation case of freckles. Tranexamic acid injections are useful for improving overall skin tone and complexion, but with disappointing results in freckle treatment

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