Sarecycline is the first new chemical entity approved for treating acne in years and the first antibiotic in four decades. It is likely to be followed by other new drugs, including clascoterone and cannabidiol (CBD) in the coming years, predicts Leon Kircik, M.D., of the Icahn School of Medicine at Mount Sinai, New York in a review of latest developments in the management of acne.1
Drug development in acne is currently focused on targeting inflammation and reworking the vehicles of existing active drugs to increase their efficacy and tolerability, he adds in a review of acne treatments published in Cutis.
Inflammation underlies the pathophysiological characteristics of acne: the proliferation of Cutibacterium acnes (formerly Propionibacterium acnes), increased sebum production with an increase in circulating androgens and faulty keratinization. Research has even indicated that the microcomedone – the first stage of an acne lesion – is essentially an inflammatory lesion, the review notes.2
“This realization has clearly influenced the approach to acne treatment but has not yielded a bevy of new treatments,” says Dr Kircik who is also affiliated with Indiana University Medical Center in Indianapolis, Physicians Skin Care in Louisville, Ky., and DermResearch and Skin Sciences, PLLC, Louisville; and Skin Sciences, PLLC, Louisville.
Topical and oral antibiotics are still primarily used to treat acne, along with topical retinoids and benzoyl peroxide, but he adds, “A better understanding of acne pathophysiology and the role of inflammation has, however, yielded a better understanding of how existing therapies treat the disease and have led to more comprehensive treatment strategies that are multitargeted.”
1. Kircik LH. What's new in the management of acne vulgaris. Cutis. 2019;104(1):48-52.
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