INDIVIDUAL ARTICLE: Real-World Clinical Case Series Utilizing Acneceuticals as Monotherapy, Adjunctive, or Maintenance Therapy for Acne Vulgaris

June 2025 | Volume 24 | Issue 6 | 08421s3 | Copyright © June 2025


Published online May 30, 2025

Hilary Baldwin MDa, Cheri Frey MDb, Adelaide Hebert MDc, Edward (Ted) Lain MDd, Evan Rieder e, Todd Schlesinger MDf

aRutgers Robert Wood Johnson Medical Center, New Brunswick, NJ; The Acne Treatment and Research Center Brooklyn, NY
bHoward University College of Medicine, Washington, DC
cMcGovern Medical School, Houston TX; Children’s Memorial Hermann Hospital, Houston, TX
dSanova Dermatology, Austin, TX
eIcahn School of Medicine at Mt Sinai Hospital, New York, NY; 36 North Moore Dermatology, New York, NY
fClinical Research Center of the Carolinas, Charleston SC; The George Washington University School of Medicine and Health Sciences, Washington, DC

Abstract
Background: Acne vulgaris is a common, multifactorial inflammatory skin disease for which there are many pharmacologic and procedural interventions. Recent publications have stressed the importance of quality skin care containing non-prescription actives (acneceuticals) in the treatment of this chronic disorder. Acne therapy is made more complicated by the diversity of presentation that includes age, gender, race, underlying skin type, product adherence, lesion morphology, and severity.
Methods: A panel of 6 dermatologists with expertise in the treatment of acne met twice for consensus conferences in March and November 2024. Discussion included the generation of 13 common disease presentations, the identification of potential cases to illustrate the presentations, and the design of 2-month case studies utilizing acneceuticals. Panelists chose new or established patients in their care who fit into the predetermined categories, provided them with the agreed-upon acneceuticals, and followed them for 2 months.
Results: Ten cases were chosen to comprise the most common therapeutic crossroads where pharmacologic or procedural interventions were not providing satisfactory control. This case study series included patients who were medication-intolerant, failing internet cures, not fully responsive to their current regimen, adult female acne patients with concomitant aging concerns, those needing maintenance therapy, and patients with issues regarding access to care.
Conclusions: Acneceuticals were found to play an important role as monotherapy, adjunctive therapy, and maintenance therapy for acne patients. The 10 cases elucidated the ability of these over-the-counter (OTC) actives to improve patient care under several clinical scenarios.

J Drugs Dermatol. 2025;24:6(Suppl 1):s3-14.


INTRODUCTION

Many quality prescription products and procedures exist for the treatment of acne vulgaris. However, they often fall short of clinician and/or patient expectations resulting in insufficient control, cutaneous intolerability, unacceptable patient cost, and delay of improvement. Clinicians, therefore, continue to search for better, more affordable therapeutic options for patients. Our patients search, too, and often find internet "cures" that are paradoxically more expensive than proven options, generally ineffective, and prolong the time to improvement with a resultant increase in acne sequelae and reduced quality of life.

In a previous review, the results of a modified Delphi consensus meeting were reported and the term "acneceutical" was introduced to describe over-the-counter (OTC) products with efficacy in the treatment of acne.1 The term “acneceuticals” was intended to be more specific and acne-centric than the term 'dermocosmetic' referring to OTC products used in general dermatologic care. In a subsequent paper, (An algorithm integrating acneceuticals into the management of acne vulgaris, J Drugs Dermatol. 2025; In press), acneceuticals were incorporated into an algorithmic approach to treatment based on patient phenotype (ie, skin type and lesion morphology) and stratified by use as monotherapy, adjunctive therapy, or
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