INTRODUCTION
Calcitonin gene-related peptide (CGRP) is a neuropeptide widely recognized for its role in vasodilation and neurogenic inflammation.1 In acne, CGRP receptors are found in sebaceous glands, where the peptide contributes to the inflammatory response triggered by Cutibacterium acnes. Blocking CGRP may mitigate this inflammation, which is key in exacerbating conditions like cystic acne.2 Recent studies have highlighted CGRP’s significance in the pathophysiology of migraines and various inflammatory skin disorders, including rosacea and acne.3 CGRP’s involvement in skin health is particularly intriguing, as it modulates inflammation through its action on cutaneous immune cells, including keratinocytes, fibroblasts, and mast cells.2 While CGRP antagonists like rimegepant are primarily used for migraine management, there is emerging evidence suggesting that these inhibitors may also offer benefits for skin conditions such as acne and rosacea.3
This case report details a patient who experienced an unexpected resolution of cystic acne after initiating rimegepant for migraine treatment. The potential role of CGRP inhibition in improving skin health offers a novel therapeutic perspective, warranting further investigation into the broader dermatological applications of CGRP antagonists.
This case report details a patient who experienced an unexpected resolution of cystic acne after initiating rimegepant for migraine treatment. The potential role of CGRP inhibition in improving skin health offers a novel therapeutic perspective, warranting further investigation into the broader dermatological applications of CGRP antagonists.
CASE REPORT
The patient is a 30-year-old woman with a long-standing history of cystic acne and migraines. Diagnosed with cystic acne at the age of 14 by her pediatrician and dermatologist, she reported that her acne primarily affected her chin and perioral areas. In her twenties, she was diagnosed with polycystic ovary syndrome (PCOS), which her endocrinologist and gynecologist believed contributed to her persistent acne.
Over the years, the patient tried various treatments, including over-the-counter acne products and prescription medications such as sulfamethoxazole/trimethoprim, oral doxycycline, topical clindamycin, and tretinoin cream. Each treatment was used intermittently for approximately one year, but none produced significant or lasting improvements. The patient had also been on oral contraceptives, norethindrone, ethinyl estradiol, and ferrous fumarate, for nearly 10 years to manage
Over the years, the patient tried various treatments, including over-the-counter acne products and prescription medications such as sulfamethoxazole/trimethoprim, oral doxycycline, topical clindamycin, and tretinoin cream. Each treatment was used intermittently for approximately one year, but none produced significant or lasting improvements. The patient had also been on oral contraceptives, norethindrone, ethinyl estradiol, and ferrous fumarate, for nearly 10 years to manage
