MIAMI BEACH, Fla. — While the armamentarium of acne treatment is vast, various novel treatments are on the horizon, according to a presenter at South Beach Symposium.
“We have been using some of these treatments for years for other conditions, but it is now time to start thinking about these treatments for acne,” Jonette Keri, MD, PhD, associate professor at the University of Miami Miller School of Medicine and chief of dermatology service at Miami VA Hospital, said during a presentation here.
In discussing the use of daylight photodynamic therapy with ALA gel for acne, Keri referred to the results of a 2019 study that showed mean inflammatory lesion count decreased for all 20 patients included in the study with no reports of adverse effects.
“Patients in this study were overall happy and reported minimal discomfort,” she said. “Clinicians have been using this for years, but daylight photodynamic therapy seems to be an effective and tolerable treatment for those with mild to severe inflammatory acne. This is a novel therapy to employ and can be used in pediatric populations as well, especially for those who do not want to take an antibiotic or use isotretinoin.”
While the armamentarium of acne treatment is vast, various novel treatments are on the horizon, according to a presenter.
Another treatment that has shown promise in patients with acne is gold microparticle therapy.
“This treatment is based upon selective photothermolysis of pilosebaceous units with follicular delivery of inert gold microparticles as an exogenous chromophore and diode laser pulses,” Keri said. “Gold microparticle therapy appears promising and could be used for the treatment of moderate to moderately severe acne.”
Novel oral supplements have also shown efficacy, according to Keri.
“I use myo-inositol every single day in my practice, especially for patients who do not want to take an antibiotic or oral contraceptives,” she said. “Research has shown that myo-inositol is associated with less testosterone levels and improvements in insulin-resistance and acne.”
Lastly, Keri discussed the use of probiotics as a novel form of acne treatment.
“Probiotics may be considered a therapeutic option or adjunct for acne vulgaris as it potentially provides a synergistic anti-inflammatory effect and reduces potential adverse effects secondary to antibiotic use. However, while probiotics for acne is a popular idea, we still need more research,” she said.
Looking ahead, various novel acne treatments are on the horizon, according to Keri.
“There is a new topical anti-androgen therapy known as clascoterone, which is a topical androgen antagonist that is currently being investigated in a phase 3 trial for its ability to treat acne,” she said. “There is also the potential for an acne vaccine, which researchers are working on right now. The severity of acne vulgaris is highly associated with the inflammatory response to Propionibacterium acnes, now referred to as Cutibacterium acnes. Future therapeutic monoclonal antibodies can be designed to specifically neutralize virulence factors of C. acnes without disrupting the optimal balance of C. acnes in the human skin microbiome and lowering the risk for drug-resistance to C. acnes. The idea in having children and young adults without acne, even if it puts me out of a job as a dermatologist, would be wonderful if it means we could help these young people with acne.”
Keri said bacterial phage therapy is another area that needs more research but has shown potential in the future of acne treatment. – by Jennifer Southall
Keri J. Novel acne treatments. Presented at: South Beach Symposium; Feb. 6-9, 2020; Miami Beach, Florida.
Disclosure: Keri reports she receives honoraria from Almirall, Dermira and Sonoma Pharmaceuticals.