Dermatology Times has helped to document some of the specialty’s biggest breakthroughs in the last 40 years. We asked the very dermatologist experts who often help us to report on dermatology milestones to weigh in on what they think made the most difference in theirs and their patients’ lives.
TO TREAT NODULAR ACNE
Isotretinoin (13-cis-retinoic acid), which was approved by the U.S. Food and Drug Administration (FDA) as an oral capsule formulation in 1982 to treat severe recalcitrant nodular acne, has proven to be a major pharmacological breakthrough for acne patients. That’s despite being challenged for its teratogenicity, according to a paper published in 2014 in the Journal of Clinical and Aesthetic Dermatology.1
“In my view, the most significant advance in dermatology has been the development and use of isotretinoin in patients with severe and recalcitrant acne,” according to Tucson, Ariz., dermatologist Norman Levine, M.D. “This one drug has improved the lives of millions of young people. No other drug or device has come close to matching this success in such a prevalent and potentially devastating skin condition.”
Dermatologists have likely felt the greatest impact among medical specialties from isotretinoin, given acne is one of the most common conditions they treat. Acne ranked first among the top 20 conditions seen by dermatologists from 2001 to 2010, according to an article published in 2014 in Cutis.2
Acne has far-reaching effects on patients’ physical and psychological wellbeing. Isotretinoin enabled dermatologists to prescribe a drug that offered some of the hardest-to-treat acne patients complete clearance, says Miami, Fla., dermatologist Jill Waibel, M.D. “This is a type of result that is unheard of in any medical treatment. Isotretinoin has undergone unwarranted demonization in years past and is finally emerging to its rightful role as ‘the drug that got bullied.’ I encourage all of my severe acne patients to try isotretinoin as long as they are not pregnant or breast feeding, as it is the only current way to achieve not only complete but permanent clearance,” she says.
AN AESTHETIC GAMECHANGER FOR SKIN: TRETINOIN
While dermatologists have used tretinoin since the 1960s, dermatologists and others didn’t realize the true potential of the retinoid’s impact on aging skin until the 1980s, researchers reported in paper published 2006 in Clinical Interventions in Aging.3
Old Metairie, La., dermatologist Patricia Farris, M.D., says the discovery that tretinoin could be used to treat wrinkles and improve the appearance of aging skin was big news for dermatologists and patients.
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2. Wilmer EN, Gustafson CJ, Ahn CS, Davis SA, Feldman SR, Huang WW. Most com- mon dermatologic conditions encountered by dermatologists and nonderma- tologists. Cutis. 2014;94(6): 285-292
3. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clin Interv Aging. 2006;1(4):327–348.
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6. Rapp SR, Feldman SR, Exum ML, Fleischer AB, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999;41(3 Pt 1):401-7.
7. DiscoverHEMANGEOL.PierreFabrePharmaceuticalswebsite: https://www. hemangeol.com/hcp/. Accessed August 2019.
8. Prasad A, Sinha AK, Kumar B, Prasad A, Kumari M. Individualized dosing of oral propranolol for treatment of infantile hemangioma: a prospective study. Pan Afr Med J. 2019;32:155.
9. Hilton L. A game-changer for children with atopic dermatitis. Dermatology Times. 2019;40(5):1, 20-21.