What should you know about microneedling with tranexamic acid?

A clinician first checks the pigmentation, active skin disease, medicines and history of abnormal scarring. After cleansing and possible numbing, the device passes over the skin. Redness, warmth, pinpoint bleeding, swelling, dryness and temporary sensitivity can follow. Skin may look darker while it heals, particularly when inflammation triggers further pigment.

Tranexamic acid has other medical uses, including treatment for heavy bleeding, but a skin procedure is not a substitute for medical assessment of abnormal menstrual bleeding. Ask what formulation is being used and whether it is intended for topical use or another route.

Tell the practitioner about pregnancy, breastfeeding, cold sores, eczema, acne, recent tanning, active infection, allergies, blood-clot history and all medicines. Follow instructions about pausing irritating skincare products. Afterward, use the recommended gentle cleanser and moisturiser, avoid picking or scrubbing, and protect treated skin from sunlight with clothing and clinician-advised sunscreen.

Keep follow-up appointments so the response can be assessed. Do not add unapproved acids, retinoids, bleaching products or home microneedling while the skin is healing.

Contact the clinic promptly for spreading redness, increasing pain, pus, fever, blistering, facial swelling or a reaction that is worsening rather than settling. Seek emergency help for breathing difficulty or swelling of the lips and tongue. Discuss new or rapidly changing pigmentation with a clinician rather than repeatedly treating it yourself.

What is causing my pigmentation? Why is this combination appropriate for my skin? What product and route will be used? How will you reduce the chance of post-inflammatory darkening, and what should I do if irritation or a cold sore appears?