Topical 10% Tranexamic Acid in Treatment of Facial Erythema and Telangiectasia With or Without Microneedling Comparative Study

Facial erythema is redness of the skin or mucous membranes, occurs because of cutaneous blood vessel dilatation and increased blood flow to the skin.it most noticeable in fair-skinned individuals, it may be transient erythema (flushing), persistent erythema, or perilesional erythema around papules and pustules .

Flushing is a transient erythema, usually a physiological phenomenon due to strong emotion, exercise, heat exposure, hyperthermia, spicy food and alcohol intake. But it may be pathological due to pheochromocytoma, carcinoid syndrome .

Persistent erythema is facial erythema that lasts for at least 3 months. It may be due to primary skin diseases such as rosacea, demodicosis, contact dermatitis, polymorphous light eruption, acne, drug-induced (cortisone, brimonidine), lupus erythematosus or due to systemic diseases as mastocytosis, dermatomyositis and hyperthyroidism Rosacea is a chronic inflammatory skin disease characterized by erythema, papules, pustules and telangiectasia affecting the central of the face, women are more often affected than men , there are several theories regarding the cause of rosacea, including genetic, environmental, vascular, and inflammatory factors, rosacea is classified into four main subtypes erythematotelangiectatic, papulopustular, phymatous, and ocular type

Cutaneous lupus erythematosus (LE) is a common autoimmune disease which is limited to the skin, manifested with malar erythema (butterfly eruption),discoid lesions, photosensitivity . It is caused by a complex interplay between genetics, hormones and environmental factors, potential environmental triggers are ultraviolet (UV) radiation and smoking. , histopathologic findings, immunofluorescence, and antinuclear antibodies will aid in making the diagnosis Contact dermatitis of the face can present as a result of a topical causative agent, and it may represent an irritant contact dermatitis, allergic contact dermatitis. A detailed patient history reveals the application of a topical formulation or the contact with a possible precipitating factor will guide the correct diagnosis .

Acne is a multifactorial disorder of the pilosebaceous unit, characterized by non-inflammatory open or closed comedones and inflammatory papules, pustules, and nodules. may present with facial redness typically affects the areas of skin with the highest density of sebaceous follicles including the face, upper chest and back, A cardinal differential diagnosis point is the presence of comedones in acne Drug induced facial erythema due to long term use of a topical corticosteroid or after its abrupt discontinuation after long-term application. It presents with erythema, telangiectasia and papules on the areas of corticosteroid application, diagnosis is based on the monomorphic nature of lesions and the reported history of chronic application of a corticosteroid.