الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Post acne erythema (PAE) is a common sequalae in many acne patients.
This is due to wound healing-related dilatory changes in microvascular structures such as the microcapillary plexus in the very superficial dermis which are not detectable by the naked eye as visible telangiectasia but as general redness. In addition, the epidermis is still in the process of maturation after repair and is therefore thinner, allowing more incident light to be reflected off the dilated microvasculature, also part of the wound healing process, which adds to the perceived “redness”. Some authors believe that this condition is also caused by exogenous stimuli, such as the application of certain anti-acne topicals and some of the drugs used are proposed to exacerbate erythema. Lesions appear as telangiectatic and erythematous macules which result from skin inflammation. In some patients, lesions may improve with time but very slowly. On the other hand, several patients suffer from persistent post acne erythema lesions which are cosmetically unacceptable to patients and are challenging to dermatologists.
Oxymetazoline is a synthetic, direct acting, imidazoline type, sympathomimetic agonist with potent vasoconstricting action that is highly selective for alpha 1 adrenoreceptors and partially selective for alpha 2 adrenoreceptors. Oxymetazoline hydrochloride 1% cream was approved by the FDA in January 2017 as a topical treatment for persistent facial erythema in rosacea patients.
Tranexamic acid (TXA) is an antifibrinolytic agent that shows a positive effect on wound healing in several studies, and it showed benefits in treating skin diseases like melasma, rosacea erythema and ultraviolet induced pigmentations. Tranexamic acid (TXA) was found to decrease erythema by repressing proinflammatory cytokines (IL-6 and TNFα) and angiogenesis.
Skin micro-needling is a technique that involves repeated puncturing of the skin using sterilized microneedles. These needles penetrate the stratum corneum and create micro channels with minimal damage to the epidermis leading to the production of growth factors. These factors induce collagen and elastin production in the papillary layer of the dermis, which helps to fa