CGRP Inhibitors, Used to Treat Migraines, May Be Helpful in Acne and Rosacea

FightAcne.com Interview with:
Christopher J. Thang, BS

John Sealy School of Medicine
The University of Texas Medical Branch, Galveston
Department of Dermatology
Massachusetts General Hospital
Harvard Medical School, Boston

Jenny Lai, PhD
Harvard Medical School,
Department of Dermatology
Brigham and Women’s Hospital
Boston, Massachusetts

John S. Barbieri, MD, MBA, Senior Author
Department of Dermatology
Brigham and Women’s Hospital, Boston, Massachusetts
Associate Editor, JAMA Dermatology

FightAcne.com: What is the background for this study?

Response: Calcitonin gene-related peptide (CGRP) mediates neurogenic inflammation and vasodilation. Prior research has demonstrated increased CGRP expression in the skin of rosacea patients who experience flushing. CGRP signaling has also been implicated in acne pathogenesis. CGRP inhibitors are used for the prevention and treatment of migraines. We investigated whether CGRP inhibition for migraine patients is associated with a decreased risk of developing acne or rosacea. 

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American Academy of Dermatology Updates ACNE Management Guidelines

Updates recommendations for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline and oral isotretinoin as well as conditional recommendations for newer medications topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, combined oral contraceptive pills, and spironolactone.

https://www.jaad.org/article/S0190-9622(23)03389-3/fulltext

Scientists Attempt to Fight Acne With Skin Bacteria Engineered to Deliver Treatment

FightAcne.com Interview with:
Nastassia Knödlseder PhD (She/Her)
Postdoctoral Researcher
Department of Medicine and Life Sciences (MELIS)
Pompeu Fabra University in Barcelona

FightAcne.com: What is the background for this study?

Response: Cutibacterium acnes is the most abundant commensal of the human skin. It inhabits the pilosebaceous units of the hair follicles where it feeds from sebum. This niche environment is of great interest since it is located deep inside the dermis close to interesting dermatological targets.

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Double Blind Study Finds Spironolactone Effective in Fighting Acne

FightAcne.com Interview with:
Prof. Miriam Santer
Professor of Primary Care Research
Primary Care Research Centre
School of Primary Care, Population Sciences and Medical Education (PPM)
Faculty of Medicine
University of Southampton, Southampton

FightAcne.com: What is the background for this study?

Response: Spironolactone has been used for the treatment of acne in women for many years, but with surprisingly little evidence from randomised trials regarding its effectiveness. This lack of evidence meant that, although it was in some national prescribing guidelines, it wasn’t in most guidelines, leading to uncertainty amongst prescribers and frustration for women trying to access this treatment.

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Study Evaluates Effect of a Biofilm Disrupting Acne Cream on Mild-to-Moderate Facial Acne

Jonathan S. Dosik, MD
Principal Investigator
TKL Research, Inc.
Fair Lawn, New Jersey

FightAcne.com: What is the background for this study?

Response: Bacterial biofilms are communities of bacteria that adhere to a wide variety of surfaces, held together by polymer matrices composed of polysaccharides, secreted proteins, and extracellular DNA.  Biofilms may penetrate into the sebum and act as an adhesive, promoting formation of microcomedones.  On the skin, bacteria adhere to the surface of the pilosebaceous unit, secreting a protective physical polysaccharide barrier which provides resistance to antimicrobial therapies. Resistance to conventional antimicrobial treatment is not only due to the physical barrier created by the rapidly established biofilm, but also the expression of hundreds of new proteins.  These proteins facilitate biofilm development by enabling bacterial surface attachment as well as clustering and secretion of extracellular polysaccharides.

Next Science, LLC. has developed acne cream products with formulations based on a material science approach which target both the biofilm and the bacteria entrenched within. This novel biofilm eradicating technology attacks biofilms in three ways:

  1. Breaks the ionic bridges that hold the biofilm together,
  2. Solubilizes the individual polymers, exposing the bacteria,
  3. Directly kills bacteria by cell lysis.
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Winlevi: Breakthrough New Cream to Fight Acne

FightAcne.com Interview with:
Michael H. Gold, M.D. FAAD
Medical Director
Gold Skin Care Center
Tennessee Clinical Research Center

FightAcne.com:  What is the background for this study?

Response: What is the background for this study? Acne is a very prevalent disease; in fact, it is the most common thing seen in dermatologists’ offices across the country.  We have not had a novel topical acne medication to treat both the inflammatory (papules and pustules) as well as the non-inflammatory acne (whiteheads and blackheads) for many years. 

Clascoterone cream (1%) is that new breakthrough topical that we have been waiting for and has a unique mechanism of action in that it targets the androgen receptors in the skin.  This unique treatment opportunity is the first new compound in over 40 years for dermatologists.

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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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Study Finds Tazarotene 0.045% Lotion Improved Both Acne and Hyperpigmentation in Black Patients

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?

ResponsePatients 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.

FDA Approves Ortho Dermatologics’ ARAZLO (Tazarotene) Lotion, 0.045%, For Acne Vulgaris

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.

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Study Finds Chromophore Gel-Assisted Blue Light Phototherapy Improves Acne



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