Acne Risk in Transgender Patients Receiving Testosterone Therapy

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.

Off-Label Spironolactone Can Fight Acne of Face, Chest and Back in Women

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. 

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FDA Approves ARAZLO (tazarotene) Lotion to Fight Acne

FightAcne.com Interview with:
Dr. Emil A. Tanghetti.  M.D.
Center for Dermatology and Laser Surgery
Sacramento, California

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.

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Fight Acne: The Influence of Social Media

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.

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