Tranexamic Acid: From Surgery to Skincare

Unlock the secrets of tranexamic acid (TXA) and discover how it is revolutionizing both dermatology and plastic surgery! Join us as we chat with Dr. Roy Kim, a distinguished plastic surgeon from San Francisco and Beverly Hills, who shares why he considers TXA his "secret weapon" in the operating room. From enhancing surgical precision to reducing excessive bleeding, TXA is making waves in delicate procedures like rhinoplasty. We'll break down the science of how it works, interrupting the coagulation cascade to offer safer surgeries and faster healing. Plus, we'll explore TXA's journey from the operating table to skincare, tackling issues like hyperpigmentation and melasma with its anti-inflammatory and melanin-reducing properties.

The conversation doesn't stop there. We'll delve into TXA's versatile applications across various surgeries, from mastectomies to breast reductions, and discuss its impact on reducing complications and recovery times. A fascinating study from Saudi Arabia even suggests it could shorten operative times in aesthetic surgeries. As we wrap up, we'll emphasize the spirit of inquiry that drives scientific innovation, encouraging listeners to remain curious and open to the myriad possibilities tranexamic acid and future discoveries hold. Whether you're a medical professional or someone intrigued by cutting-edge skincare and surgical advancements, this episode is packed with insights and inspiration.

Thank you for tuning in to this week's episode of "The Beauty Standard" with Dr. Roy Kim! If you enjoyed this episode, please make sure to subscribe, rate, and leave us a review on your favorite podcast platform. Your support helps us continue to bring you the latest insights in aesthetic medicine and beauty trends.

Connect with us on social media on Instagram - @drroykim - or X - @drroykim-  for more exclusive content, behind-the-scenes looks, and expert advice from Dr. Kim. Feel free to submit your questions or suggestions for future episodes – we'd love to hear from you!

Join us next week as we explore another fascinating topic in the world of beauty, and remember: your body, your choice, your standard!

Transcript

Speaker 1 0:01

Welcome to the Beauty Standard with Dr Roy Kim.

Speaker 2 0:04

All right, ready to jump into a deep dive on tranexamic acid.

Speaker 1 0:08

Yep sounds good.

Speaker 2 0:09

TXA you've probably heard of it. It's kind of making waves in the aesthetics world, right.

Speaker 1 0:14

Oh yeah definitely.

Speaker 2 0:15

But what I find fascinating is it's used in both dermatology and deep plastic surgery.

Speaker 1 0:21

Huh, that is interesting.

Speaker 2 0:22

It's like this multitasker you know yeah. So we've got some great sources lined up for this. We've got a blog post and YouTube video by dr Roy Kim oh, it's a plastic surgeon. Practices in San Francisco and Beverly Hills, nancy and then we'll be looking at some research articles as well.

Speaker 2 0:36

So okay, sounds good our mission, should we choose to accept it like it is to unpack how TXA is used and what the research says about its effectiveness. So, to kick things off, I was really struck by how Dr Kim described TXA in his blog. He called it his secret weapon in the OR. I mean, that's a pretty bold statement, right.

Speaker 1 1:00

It is.

Speaker 2 1:07

He even said it's like having an extra pair of hands, which I thought was like such a powerful way to put it. Yeah, I can see why that caught your attention, so maybe you can help break this down for us. How does TXA actually work? What's the science behind it?

Speaker 1 1:14

Okay, so basically, txa works by affecting this thing called the coagulation cascade. You know that's the process that your body uses to stop bleeding Right. Basically, you can think of it as this chain reaction. Like, each link in the chain is a protein and it activates the next one.

Speaker 2 1:31

Okay.

Speaker 1 1:31

And then ultimately, you know, it forms a clot.

Speaker 2 1:33

I see so it's like a domino effect, right.

Speaker 1 1:35

Yeah, exactly, and what TXA does is it comes in and stops one specific link in that chain. It targets a protein called plasmin, which is actually responsible for breaking down clots.

Speaker 2 1:47

Oh interesting, so it's not just about forming clots, it's about preventing them from being broken down too quickly.

Speaker 1 1:52

Exactly.

Speaker 2 1:53

Okay, I'm starting to get the picture, but why is this such a game changer, especially in aesthetic procedures? What's the big takeaway for our listeners?

Speaker 1 2:02

Well, let's take a rhinoplasty, for example. It's super delicate work, right? So TXA allows for, like, greater precision because the surgeon isn't constantly fighting against excessive bleeding Right Makes sense. So that means better results, potentially fewer complications and faster healing for the patient.

Speaker 2 2:18

So basically everyone wins.

Speaker 1 2:20

Pretty much, and what?

Speaker 2 2:21

about safety. I mean messing with the coagulation cascade sounds kind of you know, intense.

Speaker 1 2:26

Oh, yeah, sure, but TXA has a really solid track record actually. It's been used safely for decades in lots of different medical fields.

Speaker 2 2:34

That's reassuring to hear.

Speaker 1 2:36

Yeah, and what's even cooler is like the origin story of TXA. Dr Kim talks about this in his YouTube video Like did you know? It started out as this simple amino acid called lysine.

Speaker 2 2:46

No, I didn't know that. Yeah, that's fascinating.

Speaker 1 2:48

So lysine was like modified, and they created something called IECA.

Speaker 2 2:52

Okay.

Speaker 1 2:53

Which then got further refined into TXA.

Speaker 2 2:55

Wow, so it's like TXA has gone through its own transformation.

Speaker 1 2:58

Yeah right.

Speaker 2 3:01

So it sounds like TXA has come a long way. What I'm really curious about is this how did it make the leap from the OR to like the world of skin care?

Speaker 1 3:10

Right, good question. Well, that's where the anti-inflammatory and melanin reducing properties of TXA come into play.

Speaker 2 3:16

Melanin, that's what gives skin its color, right Yep. So by like inhibiting melanin production, txa can help with those pesky dark patches Hyperpigmentation.

Speaker 1 3:26

Exactly, and it's especially effective for melasma.

Speaker 2 3:29

Melasma, that's the one that's triggered by hormonal changes right.

Speaker 1 3:32

Often during pregnancy.

Speaker 2 3:34

Right, it can be so stubborn.

Speaker 1 3:35

Oh yeah, and it often shows up as that symmetrical butterfly rash across the cheeks.

Speaker 2 3:40

I've definitely seen that Right. Dr Kim mentioned in his blog that he recommends TXA after procedures like chemical peels and laser therapy too yeah, that makes sense, because those can sometimes make hyperpigmentation worse yeah, so TXA can kind of help prevent that so better results, less downtime yeah, exactly okay, so let's talk about the different ways TXA is actually used in skincare. I know it's in creams and lotions and stuff, but are there other ways to apply it?

Speaker 1 4:07

Oh, definitely. You've got your topical creams and lotions. Those are good for like mild to moderate cases.

Speaker 2 4:14

Okay.

Speaker 1 4:14

Then there's microneedling with TXA.

Speaker 2 4:16

Microneedling.

Speaker 1 4:17

Yeah, they use these tiny needles to make little channels in the skin Interesting, so the TXA can penetrate deeper. Oh clever, some doctors even do injectable TXA.

Speaker 2 4:27

Really.

Speaker 1 4:28

Yeah, in their offices Huh hadn't heard that about me. But that's less common.

Speaker 2 4:32

Okay.

Speaker 1 4:32

And then for like really severe melasma, they might prescribe oral TXA.

Speaker 2 4:39

So like a pill. Uh-huh, Wow. Txa is like a jack of all trades when it comes to aesthetics.

Speaker 1 4:45

It really is.

Speaker 2 4:46

And we're just scratching the surface here.

Speaker 1 4:47

Right.

Speaker 2 4:49

TXA's journey from the RR to skincare is fascinating, but there's a whole other world of research looking at its benefits in different types of surgery too.

Speaker 1 4:57

Absolutely A ton of research out there.

Speaker 2 4:59

So, like, what kind of research are we talking about here? What have they found?

Speaker 1 5:02

Well, there are some really interesting findings on how TXA is being used in rhinoplasty, facelifts, even breast surgery.

Speaker 2 5:09

Okay, I'm definitely intrigued.

Speaker 1 5:10

It's pretty remarkable stuff.

Speaker 2 5:12

All right, well, I'm ready to dive into that research. Let's move on to part two.

Speaker 1 5:15

Sounds good to me, welcome back.

Speaker 2 5:17

So you mentioned rhinoplasty, facelifts and breast surgery. What have researchers found about TXA's role in those procedures?

Speaker 1 5:25

Well, for starters, there's a whole bunch of research on TXA and rhinoplasty. Multiple studies have shown that it can really reduce bleeding, bruising and swelling.

Speaker 2 5:36

And I imagine that's especially important with a rhinoplasty right, Because minimizing swelling is key for the surgery itself and the final result exactly.

The Versatility of Tranexamic Acid

Speaker 1 5:45

Less swelling means the surgeon can see better during the procedure, so you know more precise results. And for the patient it means like a smoother recovery, potentially less discomfort so it's a win-win yeah, pretty much what about facelifts? You mentioned some research there too yeah, so studies suggest that TXA can reduce bleeding hematomas.

Speaker 2 6:05

Hematomas.

Speaker 1 6:05

Yeah, that's like collections of blood under the skin and swelling too, which could potentially mean a faster recovery.

Speaker 2 6:12

Okay, that's interesting. It seems like TXA's anti-inflammatory properties are really doing their thing.

Speaker 1 6:17

It's not just about stopping the bleeding, it's about minimizing those post-op side effects that can make recovery. You know, drag on and be uncomfortable.

Speaker 2 6:26

And what about breast surgery? What's the research shown there?

Speaker 1 6:29

So TXA has been shown to significantly reduce bleeding in procedures like mastectomies, lumpectomies and breast reductions too.

Speaker 2 6:37

Can you like talk about the implications of that, like what does reduced bleeding actually mean in these kinds of surgeries?

Speaker 1 6:44

Sure. Well, reduced bleeding means a lower risk of complications like hematomas, which sometimes, you know, need another procedure to drain them.

Speaker 2 6:52

Ugh not ideal.

Speaker 1 6:53

Right, and it also could mean less need for blood transfusions, which, you know, those always carry some level of risk.

Speaker 2 7:00

So again, TXA contributes to like a safer and smoother experience overall.

Speaker 1 7:05

Absolutely.

Speaker 2 7:06

It's wild how one compound can do so much.

Speaker 1 7:08

It really is, you know, shows the power of medical research.

Speaker 2 7:11

Yeah, for sure, but you mentioned earlier that it's not a like one size fits all solution. What did you mean by that?

Speaker 1 7:17

Well like. Even though TXA generally reduces blood loss in various surgeries, there are times when the results are like less clear, for example with blepharoplasty.

Speaker 2 7:26

With eyelid surgery right.

Speaker 1 7:27

Exactly One study showed a trend towards less bruising with TXA, but the results weren't, you know, statistically significant.

Speaker 2 7:35

So even with something as well studied as TXA, there are still some unknowns.

Speaker 1 7:40

Absolutely. It's a reminder that science is always, you know, evolving.

Speaker 2 7:44

Right Makes sense. Now you hinted at something I found super interesting. You said there's a difference in how much TXA is used across different areas of surgery.

Speaker 1 7:53

Oh yeah.

Speaker 2 7:53

Right, you said it's widely adopted in some specialties but not so much in others.

Speaker 1 8:02

Exactly so. There was a systematic review that looked at TXA studies over the past two decades and it found that, like, while TXA has become really common in craniofacial surgery, facelifts, rhinoplasty and breast surgery, it's been used way less in like microsurgery and burn care.

Speaker 2 8:15

That's so surprising. Why do you think that is? Is it like safety concerns specific to those areas?

Speaker 1 8:19

That's a good question. Honestly, the review didn't like give a clear answer. It could be, you know, a bunch of different things Differences in surgical techniques, a lack of awareness among those surgeons, or maybe even a perception of risk that might not be accurate.

Speaker 2 8:34

So there's this potential knowledge gap.

Speaker 1 8:37

I think so yeah.

Speaker 2 8:38

But the good news is, like this review highlighting that disparity could spark more research, maybe it'll encourage surgeons in those areas to like reconsider using TXA. I hope so. That'd be awesome. Speaking of research, you mentioned a study from Saudi Arabia that looked at TXA in aesthetic surgery.

Speaker 1 8:56

Yes, that's right. They looked at like all kinds of procedures abdominoplasties, breast augmentations, facial stuff, liposuction. They wanted to see if TXA had any effect on complication rates and overall outcomes.

Speaker 2 9:07

What did they find?

Speaker 1 9:08

Well, the results were pretty interesting. Patients who got TXA had shorter operative times A&D, shorter hospital stays compared to those who didn't.

Speaker 2 9:16

Oh wow, that's significant. Seems like it points to a faster recovery, which is great.

Speaker 1 9:20

Yeah, definitely, and it kind of lines up with, you know, txa's anti-inflammatory effects. Reducing inflammation could speed up healing.

Speaker 2 9:27

Right. So it's not just about the bleeding during the procedure, it's the after effects too.

Speaker 1 9:31

Exactly, and they found no big difference in the rate of complications between the groups. Meaning TXA didn't seem to, you know, increase the risk of anything bad happening.

Speaker 2 9:41

That's good to hear, but you did mention earlier that it was a retrospective study, so it looked back at existing records.

Speaker 1 9:48

Yeah, so it's not like a controlled experiment.

Speaker 2 9:50

So we need more research. Yeah, randomized controlled trials, that kind of thing.

Speaker 1 9:53

Yeah, to confirm these findings. I got it.

Speaker 2 9:56

Now there was one thing in this study I wanted to ask you about. They found that the type of procedure seemed to influence whether surgeons chose to use TXA.

Speaker 1 10:03

Yeah, they noticed that procedures like trunk aesthetic surgery which you know that includes tummy tucks and liposuction were more likely to involve TXA.

Speaker 2 10:15

Why do you think that is? Is it because those procedures involve larger areas, so like more potential for blood loss?

Speaker 1 10:22

It could be that, but I think it's probably a few things. Those procedures are known to have a higher risk of complications in general, so surgeons might be more inclined to use TXA as a preventative measure.

Speaker 2 10:36

Okay, so it's about minimizing risk.

Speaker 1 10:38

Exactly, and it highlights the importance of considering the specific procedure and the individual patient's risk factors.

Speaker 2 10:45

Right, so like personalized medicine.

Speaker 1 10:47

Exactly. Speaking of personalized medicine, I think it's time to switch gears. Let's talk about TXA's use in treating melasma.

Speaker 2 10:54

Okay, I'm ready for that. Let's dive into those findings. In part three. We're back for the final part of our deep dive on TXA.

Speaker 1 11:01

And we're finishing up with a look at how TXA is helping people who have melasma.

Speaker 2 11:05

Yeah, it's such a common problem, especially for women, and it can be like really tough to deal with.

Speaker 1 11:10

Oh for sure, Melasma can be super persistent and the traditional treatments well, they haven't always been that great. But TXA, it's offering some new hope.

Speaker 2 11:19

Before we jump into the specifics, can you like remind us what melasma is and what causes it?

Speaker 1 11:24

Okay, so melasma is a skin condition where you get these brown or grayish brown patches on your face, usually on the cheeks, forehead, nose, upper lip. It's often triggered by hormonal changes. That's why it's so common in women during pregnancy.

Speaker 2 11:38

Yeah, and even after pregnancy it can be really hard to get rid of.

Speaker 1 11:41

Exactly. Sun exposure and some medications can also play a role. It's not totally clear why, but it seems like those triggers can cause an overproduction of melanin in some areas of the skin.

Speaker 2 11:53

Okay, so where does TXA come in? How's it used to treat this?

Speaker 1 11:57

Well, remember how we talked about TXA having those melanin reducing properties, Yep. So for melasma there are a bunch of different ways it's being used. We've got topical TXA creams and lotions. Those are getting really popular. They can be pretty effective for mild to moderate cases.

Speaker 2 12:11

I've definitely seen those around more and more. Is there research to back that up? Like does it actually work?

Speaker 1 12:16

Oh yeah, there have been a bunch of studies. They show topical TXA can significantly lighten those dark patches from melasma. Basically it works by inhibiting tyrosinase.

Speaker 2 12:26

Tyrosinase. That's an enzyme that's, like, really important in melanin production, so it's not just reducing existing melanin, it's preventing new melanin from forming Exactly, and there's also microneedling with TXA.

Speaker 1 12:39

I think that's a really cool approach.

Speaker 2 12:41

You mentioned that before. Can you walk us through how that works?

Speaker 1 12:43

Sure. So with microneedling they use a device that has tiny needles and they make like micro injuries in the skin. Micro injuries yeah, tiny ones. Those actually stimulate collagen production and they also create these little channels so topical medications can get in deeper.

Speaker 2 13:00

So when you combine that with TXA, you're basically giving the TXA a direct route to those melanin-producing cells.

Speaker 1 13:06

Right, exactly, and this combo can lead to faster, more noticeable results compared to just using topical TXA alone.

Speaker 2 13:13

That makes sense, and for more severe cases there's oral TXA right.

Speaker 1 13:17

Yeah, so oral TXA in pill form is often prescribed for severe melasma that hasn't responded to other treatments. Some doctors also offer injectable TXA in their offices, but that's not as common, wow.

Speaker 2 13:29

So many options.

Speaker 1 13:30

Right, it seems like there's a whole toolbox of TXA options to tackle melasma.

Speaker 2 13:36

That's amazing.

Speaker 1 13:37

Yeah, and the research is showing some really promising results for TXA in treating melasma. No matter how it's delivered.

Speaker 2 13:43

That's great news but, like we always say, txa isn't a magic bullet. It's not a cure for melasma and it might not work for everyone.

Speaker 1 13:52

Definitely. It's super important to talk to a dermatologist or a qualified healthcare professional. They can help you figure out if TXA is right for you and what the best approach is based on your situation and medical history.

Speaker 2 14:05

Couldn't agree more. So, wow, this deep dive has been so informative. We've learned a ton about TXA, from its use in surgery to how it's becoming more and more popular in skincare.

Speaker 1 14:15

It's been quite a journey, hasn't it?

Speaker 2 14:16

It has. We've seen how TXA has evolved from this surgical tool to this versatile compound with applications across multiple areas of medicine.

Speaker 1 14:24

And who knows what the future holds. There's so much more research going on.

Speaker 2 14:31

That's what I was thinking. You know, one thing that's really stuck with me throughout this whole deep dive is even with all the research that's been done, there are still so many questions we don't have answers to and so many possibilities that haven't been explored yet.

Speaker 1 14:40

Yeah, that's the cool thing about science Always pushing the boundaries.

Speaker 2 14:43

Exactly so. My takeaway is we've got to stay curious, keep asking questions, be open to new discoveries.

Speaker 1 14:51

I love that. Curiosity is what drives innovation. It leads to breakthroughs that make people's lives better.

Speaker 2 14:57

Absolutely Well. On that note, I think it's time to wrap up this deep dive.

Speaker 1 15:01

Yeah, I think we've covered a lot.

Speaker 2 15:03

Thanks for joining us on this exploration of tranexamic acid. Until next time.

Speaker 1 15:08

Bye. Thank you for listening to the Beauty Standard with Dr Roy Kim. Make sure to follow for future topics and episodes.