FightAcne.com Interview with: Miesha Merati, DO, FAAD The Parker Skin and Aesthetic Clinic Beachwood, Ohio
FightAcne.com: Would you briefly explain the microneedling procedure and what it is used for?
Response:Microneedling has gained popularity over the recent years due to its accessibility, relative ease of use, and impressive results for a variety of skin concerns including scar remodeling, pigmentary disorders, alopecia, acne, rejuvenation and rhytide reduction. It is a minimally invasive procedure that uses a device with needles ranging from 0.5 to 3mm in length that puncture the epidermis, and sometimes the dermis in a controlled fashion. Penetration of the skin allows for the release of growth factors, collagen, elastin, and dermal drug delivery. Microneedling exists in many forms, including the roller device, dermastamp, automated pen, and fractional radiofrequency.
FightAcne.com Interview with: Erica Dommasch, MD, MPH Department of Dermatology Assistant Professor Harvard Medical School
Dr. Dommasch
FightAcne.com: What is the background for this study?
Response: Prior studies have suggested that testosterone use among transgender/gender minority patients may be linked to the development of acne, but they have been limited by small patient populations and have had varying conclusions. Acne can be a debilitating condition for many patients but may be especially harmful for transgender patients who already experience stigma and discrimination.
FightAcne.com: What are the main findings?
Response: We conducted a large, retrospective cohort study including 988 transgender patients who newly initiated testosterone to examine the incidence and predictors of acne in this population.
We found that after 2 years, 25% of these patients developed a new diagnosis of acne. This risk was highest among the youngest age group in our study (age 18 to 20.75 years), with 29.6% of these patients developing acne over 2 years.
FightAcne.com Interview with: John S. Barbieri MD MBA University of Pennsylvania Philadelphia, PA 19104
FightAcne.com: What is the background for this study?
Response:Spironolactone is used off-label for the treatment of acne in women. However, data on its effectiveness is limited to small trials and retrospective studies that often use subjective, qualitative outcomes. As a result, we sought to characterize the effectiveness of spironolactone for acne in routine clinical practice, using objective, quantitative outcomes such as the Comprehensive Acne Severity Scale. We also evaluated acne both on the face and also on the chest and back.
FightAcne.com: What are the main findings?
Response:We found that spironolactone is effective for both acne on the face as well as for acne on the chest and back. Similar to prior studies, we found that spironolactone can take a few months to reach peak effectiveness, so patience is importance when starting treatment with spironolactone. We found that doses 100mg/day or higher tended to be better than lower doses.
FightAcne.com Interview with: Dr. Fran Cook-Bolden, MD Diplomate of the American Board of Dermatology Director of FCB Dermatology and Wellness, Cosmetic & Laser Surgery and Clinical Assistant Professor, Weill Cornell, NY
FightAcne.com: What is the background for this study? What are the main findings?
Response: Patients with skin of color have a higher risk of acne and inflammation-related complications, including post-inflammatory hyperpigmentation (PIH). Topical retinoids such as tazarotene treat acne in part by reducing inflammation. However, skin irritation and other skin reactions may limit the use of some tazarotene gel and cream formulations. A lower-dose tazarotene 0.045% lotion formulation (Arazlo™, Ortho Dermatologics) was recently developed to treat acne.
FightAcne.com: How does Tazarotene Cream differ from other medication groups for acne?
Response:To clarify, our results are on tazarotene lotion, not tazarotene cream. Tazarotene 0.045% lotion is the first lotion formulation of tazarotene, which was created using polymeric emulsion technology. The benefits of this new technology are that the lotion is highly spreadable, and it allows for more efficient delivery of tazarotene deep into the skin while reducing the potential for skin irritation. In a previous study, tazarotene 0.045% lotion had comparable efficacy to tazarotene 0.1% cream but with fewer side effects.
FightAcne.com Interview with: Dr. Emil A. Tanghetti. M.D. Center for Dermatology and Laser Surgery Sacramento, California
Dr. Tanghetti
FightAcne.com: What is the background for this announcement?
Response: ARAZLOTM (tazarotene) Lotion, 0.045%, was approved by the U.S. Food and Drug Administration in December 2019 and is indicated for the topical treatment of acne vulgaris in patients nine years of age and older. This week, Ortho Dermatologics announced that ARAZLO is available commercially to healthcare professionals.
FightAcne.com: What are the main findings of your study? : Tanghetti EA, Kircik LH, Green LJ, et. Al. A Phase 2 multicenter, double-blind, randomized, vehicle controlled clinical study to compare the safety and efficacy of a novel tazarotene 0.045% lotion and tazarotene 0.1% cream in the treatment of moderate-to-severe acne vulgaris. J Drugs Dermatol. 2019;18(6):542-548
Response: In this Phase 2, head-to-head study, ARAZLO and Tazorac (tazarotene) Cream 0.1% showed similar treatment success rates and similar reductions in both inflammatory and non-inflammatory lesions over 12 weeks. While there were no significant differences in patient satisfaction or quality of life between the two treatments and both were well-tolerated, there were about double the number of treatment-related adverse events with Tazorac (5.6% with Tazorac vs. 2.9% with ARAZLO).
Additionally, ARAZLO was evaluated in two Phase 3 multicenter, randomized, double-blind, vehicle-controlled clinical trials in 1,614 patients with moderate to severe acne. In both Phase 3 studies, ARAZLO showed superiority to vehicle for all primary efficacy endpoints (p<.001). ARAZLO was also shown to be generally well-tolerated in the clinical study population.
In the topical retinoid world, consensus and head-to-head studies all have strongly suggested that tazarotene 0.1% cream and gel is the most potent retinoid in this space. However, irritation has always been a concern and has been one of the main impediments to widespread use. ARAZLO provides the same efficacy of tazarotene 0.1% cream with a significantly better tolerability profile.
FightAcne.com Interview with: Zachary Zinn, MD Assistant Professor J.W. Ruby Memorial Hospital, WVU Medicine Children’s Residency Program DirectorDepartment of Dermatology Health Sciences Center Morgantown, WV Dr. Zinn is a member of the Society for Pediatric Dermatology
FightAcne.com: What is the background for this study?
Response: We noticed that many patients used acne products based on social media recommendations, oftentimes without therapeutic success. Our goal was to better understand the influence of social media on acne treatment. This was a survey-based study given to patients presenting to an academic dermatology practice.
This document was completed by Martina Cartwright, PhD Senior Director, Medical Affairs and Dr. Alessndro Mazzetti, Chief Medical Officer, Cassiopea. The product being discussed, clascoterone cream 1% is NOT FDA approved and is for informational purposes only.
FightAcne.com: What is the background for this study?
Response: Androgens play a significant role in the development of acne in both males and females. Oral medications that reduce androgens are used to treat acne in females, but due to side effects, are unsuitable for males. Clascoterone cream 1% is a novel, topical androgen receptor inhibitor under FDA review as possibly a new first in class treatment for acne in both males and females. These pivotal phase 3 studies demonstrated favorable efficacy and safety with low adverse event rates.
FightAcne.com Interview with: Emil Tanghetti, M.D., FAAD Center for Dermatology and Laser Surgery Sacramento, California
FightAcne.com: What is the
background for this study? What are the
main findings?
Response: This new tazarotene lotion is a game changer, by enhancing the delivery of the active drug with the polymeric lotion vehicle we are able to get efficacy that is similar to the higher concentration of tazarotene. This vehicle also permits the simultaneous delivery of emollients and humectants. Both these factors provide a much better tolerability profile than the older preparations. The main impediment in the past to using tazarotene was irritation. With this new formulation, this concern is no longer of paramount importance. This vehicle is cosmetically elegant and highly spreadable, which should make it an ideal product for the face, chest and back.
This new study if a follow up of a study evaluating the KLOX BioPhotonic System, an LED blue light device using photo-converter chromophores, that demonstrated ” significantly improved moderate and severe facial acne vulgaris with an excellent safety profile”.
The current study extended the findings an additional 12 weeks and found ” The BioPhotonic System, which is comprised of LED blue light phototherapy and photo-converter chromophores, provides long-term efficacy and safety in the treatment of acne vulgaris, with a rate of compliance above what is generally observed in a young population of patients suffering from acne vulgaris, especially in light of sequential enrollment in a study treating one hemiface.”
Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
Nikolis, A., Fauverghe, S., Scapagnini, G., Sotiriadis, D., Kontochristopoulos, G., Petridis, A., Rigopoulos, D., Dessinioti, C., Kalokasidis, K. and Antoniou, C. (2017), An extension of a multicenter, randomized, split-face clinical trial evaluating the efficacy and safety of chromophore gel-assisted blue light phototherapy for the treatment of acne. Int J Dermatol. doi:10.1111/ijd.13814
A Swedish study found #thatmenwithacnehadastatisticallysignificantincreasedriskofprostatecancerlaterinlifecompared withmenwithoutacne”. The link between the two may be the acne-associated bacteria Propionibacterium acnes.
