{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:29:00Z","timestamp":1790659740596,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n There is a lack of evidence on the therapeutic efficacy of topical tranexamic acid (TA) for the treatment of acne-related postinflammatory hyperpigmentation (PIH). The current study aimed to assess the efficacy of twice-daily administration of 20% azelaic acid (AZA) cream versus 5% TA solution for the treatment of PIH in patients with acne vulgaris.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n Patients in the present single-blinded randomized clinical trial were randomized into AZA or TA groups for 12 weeks. The rate of healing was assessed by scoring recorded photographs based on postacne hyperpigmentation index (PAHI) at baseline, 4\n th<\/jats:sup>\n , 8\n th<\/jats:sup>\n , and 12\n th<\/jats:sup>\n weeks. The frequency of side effects was examined and recorded at each study time point.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Thirty volunteers in each treatment group completed the intervention. PAHI score in both AZA and TA groups improved during the study course (P\n time<\/jats:sub>\n < 0.001, for both groups). However, mean PAHI scores were comparable in the two groups (P\n group<\/jats:sub>\n = 0.05). No significant interaction was also found between time and treatments in terms of PAHI score (P\n time \u00d7 group<\/jats:sub>\n = 0.66). The frequency of treatment-related side effects was significantly higher in the AZA group compared to the TA group at week 4 of treatment (\n P<\/jats:italic>\n < 0.05). However, no significant difference was observed in the frequency of reported side effects at weeks 8 and 12 of the treatment (\n P<\/jats:italic>\n > 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n Topical administration of 20% AZA cream and 5% TA solution was comparably efficient in the treatment of acne-related PIH with a significantly better safety profile of TA in the 1\n st<\/jats:sup>\n month of the treatment.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jrms.jrms_443_22","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T11:32:13Z","timestamp":1680262333000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["A comparative study of 20% azelaic acid cream versus 5% tranexamic acid solution for the treatment of postinflammatory hyperpigmentation in patients with acne vulgaris: A single-blinded randomized clinical trial"],"prefix":"10.4103","volume":"28","author":[{"given":"Mohammadreza","family":"Sobhan","sequence":"first","affiliation":[{"name":"Department of Dermatology, School of Medicine, Psoriasis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaheh","family":"Talebi-Ghane","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Modeling of Non-Communicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elnaz","family":"Poostiyan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,4]]},"reference":[{"key":"R1-20240830","first-page":"18","article-title":"Psychosocial impact of postinflammatory hyperpigmentation in patients with acne vulgaris","volume":"10","author":"Darji","year":"2017","journal-title":"J Clin Aesthet Dermatol"},{"key":"R2-20240830","doi-asserted-by":"crossref","first-page":"87","DOI":"10.2165\/11536930-000000000-00000","article-title":"Postinflammatory hyperpigmentation: Etiologic and therapeutic considerations","volume":"12","author":"Callender","year":"2011","journal-title":"Am J Clin Dermatol"},{"key":"R3-20240830","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1007\/s40257-017-0333-6","article-title":"Postinflammatory hyperpigmentation: Epidemiology, clinical presentation, pathogenesis and treatment","volume":"19","author":"Kaufman","year":"2018","journal-title":"Am J Clin Dermatol"},{"key":"R4-20240830","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1007\/s40257-021-00633-4","article-title":"The Pathogenesis and management of acne-induced post-inflammatory hyperpigmentation","volume":"22","author":"Elbuluk","year":"2021","journal-title":"Am J Clin Dermatol"},{"key":"R5-20240830","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/j.1365-4632.2007.03351.x","article-title":"Hydroquinone-induced exogenous ochronosis: A report of four cases and usefulness of dermoscopy","volume":"47","author":"Charl\u00edn","year":"2008","journal-title":"Int J Dermatol"},{"key":"R6-20240830","first-page":"58","article-title":"Double-blind comparison of azelaic acid and hydroquinone in the treatment of melasma","volume":"143","author":"Verallo-Rowell","year":"1989","journal-title":"Acta Derm Venereol Suppl (Stockh)"},{"key":"R7-20240830","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1111\/j.1473-2165.2011.00580.x","article-title":"Comparative study of therapeutic effects of 20% azelaic acid and hydroquinone 4% cream in the treatment of melasma","volume":"10","author":"Farshi","year":"2011","journal-title":"J Cosmet Dermatol"},{"issue":"Suppl 1","key":"R8-20240830","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1159\/000354888","article-title":"Azelaic acid: Properties and mode of action","volume":"27","author":"Sieber","year":"2014","journal-title":"Skin Pharmacol Physiol"},{"key":"R9-20240830","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1111\/ced.12835","article-title":"Efficacy and possible mechanisms of topical tranexamic acid in melasma","volume":"41","author":"Kim","year":"2016","journal-title":"Clin Exp Dermatol"},{"key":"R10-20240830","doi-asserted-by":"crossref","first-page":"150","DOI":"10.3109\/14764172.2012.685478","article-title":"Topical 5% tranexamic acid for the treatment of melasma in Asians: A double-blind randomized controlled clinical trial","volume":"14","author":"Kanechorn Na Ayuthaya","year":"2012","journal-title":"J Cosmet Laser Ther"},{"key":"R11-20240830","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1111\/srt.12107","article-title":"Reduction in facial hyperpigmentation after treatment with a combination of topical niacinamide and tranexamic acid: A randomized, double-blind, vehicle-controlled trial","volume":"20","author":"Lee","year":"2014","journal-title":"Skin Res Technol"},{"key":"R12-20240830","doi-asserted-by":"crossref","first-page":"e96","DOI":"10.1097\/DSS.0000000000002520","article-title":"Clinical efficacy of topical tranexamic acid with microneedling in melasma","volume":"46","author":"Kaur","year":"2020","journal-title":"Dermatol Surg"},{"key":"R13-20240830","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1111\/jocd.12152","article-title":"Comparison of therapeutic effects of liposomal tranexamic acid and conventional hydroquinone on melasma","volume":"14","author":"Banihashemi","year":"2015","journal-title":"J Cosmet Dermatol"},{"key":"R14-20240830","first-page":"753","article-title":"Topical tranexamic acid as a promising treatment for melasma","volume":"19","author":"Ebrahimi","year":"2014","journal-title":"J Res Med Sci"},{"key":"R15-20240830","doi-asserted-by":"crossref","first-page":"344","DOI":"10.36849\/JDD.5622","article-title":"The use of tranexamic acid to prevent and treat post-inflammatory hyperpigmentation","volume":"20","author":"Lindgren","year":"2021","journal-title":"J Drugs Dermatol"},{"key":"R16-20240830","doi-asserted-by":"crossref","first-page":"e15103","DOI":"10.1111\/dth.15103","article-title":"Tranexamic acid versus fractional carbon dioxide laser in post-acne hyperpigmentation","volume":"34","author":"Tawfic","year":"2021","journal-title":"Dermatol Ther"},{"key":"R17-20240830","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s13555-017-0195-0","article-title":"Therapeutic effects of topical tranexamic acid in comparison with hydroquinone in treatment of women with melasma","volume":"7","author":"Atefi","year":"2017","journal-title":"Dermatol Ther (Heidelb)"},{"key":"R18-20240830","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1111\/j.1365-4632.2004.02267.x","article-title":"Postinflammatory hyperpigmentation: A common but troubling condition","volume":"43","author":"Lacz","year":"2004","journal-title":"Int J Dermatol"},{"key":"R19-20240830","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.jaad.2017.01.036","article-title":"Postinflammatory hyperpigmentation: A comprehensive overview: Treatment options and prevention","volume":"77","author":"Chaowattanapanit","year":"2017","journal-title":"J Am Acad Dermatol"},{"key":"R20-20240830","first-page":"586","article-title":"Efficacy and safety of azelaic acid (AzA) gel 15% in the treatment of post-inflammatory hyperpigmentation and acne: A 16-week, baseline-controlled study","volume":"10","author":"Kircik","year":"2011","journal-title":"J Drugs Dermatol"},{"key":"R21-20240830","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/S0149-2918(98)80076-3","article-title":"Azelaic acid 20% cream in the treatment of facial hyperpigmentation in darker-skinned patients","volume":"20","author":"Lowe","year":"1998","journal-title":"Clin Ther"},{"key":"R22-20240830","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/j.1365-4362.1995.tb03583.x","article-title":"Azelaic acid: Pharmacokinetic and pharmacodynamic properties and its therapeutic role in hyperpigmentary disorders and acne","volume":"34","author":"Nguyen","year":"1995","journal-title":"Int J Dermatol"},{"key":"R23-20240830","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3109\/14764172.2015.1114634","article-title":"Combination treatment of low-fluence Q-switched Nd: YAG laser and oral tranexamic acid for post-inflammatory hyperpigmentation due to allergic contact dermatitis to henna hair dye","volume":"18","author":"Lee","year":"2016","journal-title":"J Cosmet Laser Ther"},{"key":"R24-20240830","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1080\/14764172.2018.1444770","article-title":"Intradermal tranexamic acid injections to prevent post-inflammatory hyperpigmentation after solar lentigo removal with a Q-switched 532-nm Nd: YAG laser","volume":"20","author":"Sirithanabadeekul","year":"2018","journal-title":"J Cosmet Laser Ther"},{"key":"R25-20240830","doi-asserted-by":"crossref","first-page":"373","DOI":"10.3109\/09546634.2015.1115812","article-title":"Topical tranexamic acid as an adjuvant treatment in melasma: Side-by-side comparison clinical study","volume":"27","author":"Chung","year":"2016","journal-title":"J Dermatolog Treat"},{"key":"R26-20240830","doi-asserted-by":"crossref","first-page":"502","DOI":"10.29271\/jcpsp.2019.06.502","article-title":"Combination of oral tranexamic acid with topical 3% tranexamic acid versus oral tranexamic acid with topical 20% azelaic acid in the treatment of melasma","volume":"29","author":"Malik","year":"2019","journal-title":"J Coll Physicians Surg Pak"}],"container-title":["Journal of Research in Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jrms.jrms_443_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:12:43Z","timestamp":1787166763000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jrms.jrms_443_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/jrms.jrms_443_22","relation":{},"ISSN":["1735-1995","1735-7136"],"issn-type":[{"value":"1735-1995","type":"print"},{"value":"1735-7136","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]},"assertion":[{"value":"2022-06-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}