JDD Special Focus

Acne

Stay up-to-date on new clinical findings in Acne View the latest articles, case reports, supplements, CME activities, Podcast episodes and more!

 

Podcast Episodes

Ask the Investigator: Acne, OCPs, and a Side Order of Practical Pearls for the Adolescent Patient

JDD Podcast host Dr. Adam Friedman gets first-hand insight from internationally acclaimed pediatric dermatologist Dr. Lawrence Eichenfield on his recent study entitled “Hormonal Contraceptives and Acne: A Retrospective Analysis of 2147 Patients” published in the June 2016 edition of the Journal of Drugs of Dermatology. Want a refresher on the use of OCPs in Acne?

Interested in learning how to initiate a patient based survey study? Just curious how a leader in the field gets an uninterested adolescent to be compliant and engaged in his/her acne care? These are just a few of the practical pearls provided.

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Editorials

Virtual Exams No Substitute for In-Person Care of Acne and Rosacea

Some dermatologists may be surprised to hear that the concept of teledermatology originated 25 years ago, and has slowly increased in usage, primarily for the purpose of providing care to those in underserved areas.1 The challenges created by the COVID19 pandemic has rapidly accelerated both interest and usage of telemedicine by dermatologists, with the American Academy of Dermatology and other dedicated groups responding quickly to provide guidance on how to integrate teledermatology into real-world dermatology practice effectively, and hopefully with avoidance of technical, medicolegal, and financial pitfalls.2 Despite differences in opinion on whether teledermatology is beneficial to the specialty, it does provide some positive aspects for patients such as decreased travel time, faster access to care, and ability to reach underserved geographic areas. On the other hand, there are many challenges related to completeness of the visit, quality of images, legal considerations, individual state regulations, security issues, lack of a true sense of connection between the patient and clinician, and conflicts in management due to patients who independently seek care from multiple clinicians simultaneously. Marked efforts are also being made to assure proper education on coding and billing for teledermatology services.2,3

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Treating Acne With Topical Antibiotics: Letter to the Editor

Dear Editor,

I write to you to express concern about the recently published article by Bonati and Dover, Treating acne with topical antibiotics: current obstacles and the introduction of topical minocycline as a new treatment option.1 In articles of this type, it is fully understood that the intent behind presenting comparisons between established and/or emerging products is to further educate the dermatology community on pharmaceutical innovation occurring within the specialty. The article in question seeks to draw comparisons between two emerging topical products each containing minocycline at varying concentrations (BPX-01 and FMX101) and each being evaluated for the treatment of acne vulgaris. My primary concerns are specifically the following:

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Articles

Treatment of Moderate to Severe Acne and Scars With a 650-Microsecond 1064-nm Laser and Isotretinoin

Laser procedures for acne and acne scars have traditionally been postponed for at least 6 to 8 months after the end of systemic isotretinoin therapy. Lower dosages with more modern laser devices having unique energy parameters of high power in microsecond pulse durations have made it possible to administer laser therapy during or shortly after completion of isotretinoin therapy, thus reducing the risk of side effects of isotretinoin.

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The Fate of Active Acne and Acne Scars Following Treatment With Fractional Radiofrequency

Acne vulgaris (AV) is a common skin disorder that may result in long-lasting acne scars. Techniques such as delivering fractional radiofrequency (RF) energy through miniature pins or needles have been utilized to manage active acne and acne scars. Skin restoration through dermal remodeling, neo-collagenesis, neo-elastogenesis, and epidermal re-newal are typical results of such treatments.

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Supplements

Androgens, Androgen Receptors, and the Skin

Of the four primary pathogenic factors that drive acne vulgaris—androgen excess, increased sebum production, faulty keratinization, and overgrowth of C. acnes—androgen excess has been the most elusive therapeutic target. Oral contraceptive pills (OCPs) have direct effect on circulating hormones, but their potential use is limited to a subset of women. As such, a sizable portion of the population affected by acne vulgaris cannot even consider treatment with OCPs. While these systemic agents are generally associated with a low risk profile and have a history of safe and effective use, they are not entirely risk-free. Indirect androgen modulation through the use of spironolactone has become increasingly popular. Again, while generally safe and effective, this systemic treatment is not without risks and contraindications and it is also limited to a subset of female patients.

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Topical Vehicle Formulations in the Treatment of Acne

Topical treatment is the mainstay of acne therapy. The most commonly prescribed topical medications for acne include benzoyl peroxide, clindamycin, and retinoids. Despite their effectiveness in treating mild to moderate acne vulgaris, these topical medications are found to be irritating, and are historically associated with poor tolerability and diminished patient adherence. Thus, choosing the right formulation that will be effective and well tolerated is essential. Novel formulations that optimize drug concentration and utilize improved delivery vehicles have helped to enhance the tolerability and efficacy, and allow for less frequent application or co-application of drugs that were previously considered incompatible. This article will review the goals of topical therapy for the treatment of acne, in addition to common therapies and their challenges. Advanced formulations and combination formulations of benzoyl peroxide, clindamycin, and tretinoin will also be discussed. J Drugs Dermatol. 2018;17(6 Suppl):s6-10.

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Matrix Revisited: Innovative Approach for Tretinoin

The history of tretinoin and its use in dermatology is a testament both to the drug’s well-established efficacy and its potential to cause skin irritation. Over more than four decades, the drug that launched the retinoid class into the market has been used in the topical management of acne, either alone or in combination. In fact, current consensus acne treatment guidelines rely heavily on retinoids, as they address several aspects of acne pathogenesis— they are comedolytic, resolve the precursor microcomedone, and are anti-inflammatory— without posing any risk for antibiotic resistance.1

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Case Reports

Efficacy and Safety of Sarecycline, a Novel, Once-Daily, Narrow Spectrum Antibiotic for the Treatment of Moderate to Severe Facial Acne Vulgaris: Results of a Phase 2, Dose-Ranging Study

 There is a need for new oral antibiotics for acne with improved safety profiles and targeted antibacterial spectra. Sarecycline is a novel, tetracycline-class antibiotic specifically designed for acne, offering a narrow spectrum of activity compared with currently available tetracyclines, including less activity against enteric Gram-negative bacteria. This phase 2 study evaluated the efficacy and safety of three doses of sarecycline for moderate to severe facial acne vulgaris.

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Dermatology News

View the Latest Skin of Color, Anti-Aging, Aesthetic, and Medical Dermatology Articles Now

| JDD Highlights, Skin of Color | No Comments
The July issue of the Journal of Drugs in Dermatology is available now. This month, we focus on Skin of Color, with special features on Anti-Aging, Aesthetic, and Medical Dermatology.…

Culturally Competent Care for LGBT Patients in Dermatology Clinics

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We developed an anonymous, online survey to investigate dermatology practice characteristics relevant to LGBT patients. Alexander M. Cartron BS, Sorana Raiciulescu MS, John C. Trinidad MD MPH Lesbian, gay, bisexual,…

An Analysis of Skin of Color Dermatology Related Content on Instagram

| Aesthetics, Skin of Color | No Comments
Patients are utilizing internet resources and social media to learn of dermatologic conditions and possible treatments. However, no studies about skin of color dermatology content available on different social media…

Developing a Topical Adjunct to Injectable Procedures

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"In vivo testing of bruising resolution demonstrated that at day 2/3, participants using the study product (INhance Post-Injection Serum with TriHex Technology®, Alastin Skincare, Inc. Carlsbad, CA) had 73% less…