Background: Post acne erythema is a common sequalae of acne with no gold standard treatment. Unfortunately, complete clearance of acne erythema may not always be achieved, therefore it is a therapeutic challenge. Aim: To compare the efficacy of Q-switched 1064 nm Nd:YAG laser when combined with topical OXZ on half of the face and topical TXA on the other half for PAE. Methods: A controlled trial was conducted with 30 patients having PAE selected from the outpatient clinic of Dermatology, department of Benha University Hospitals. All patients were subjected to Q switched Nd:YAG laser followed by topical treatment using split face model: OXZ on the right side and TXA on the left side. This regimen was repeated three times at a 2-weeks interval. Therapeutic outcomes were evaluated by digital photography of the patients. Results: The count and the grade of PAE on both sides of the face were significantly improved after the end of both treatments compared to the baseline. Pain, and erythema were the most commonly reported side effects. Conclusion: A new effective combination of Q-switched 1064 nm Nd:YAG laser therapy with topical vasoconstrictors regimen either TXA or OXZ has a promising role in PAE treatment with fewer side effects for PAE.