![acne](https://www.dermatologytimes.com/sites/default/files/Acne%20%28%C2%A9AdobeStock_Frank_29052515%29_7.jpeg "<p>“A better understanding of acne pathophysiology and the role of inflammation has … yielded a better understanding of how existing therapies treat the disease and have led to more comprehensive treatment strategies that are multitargeted," says Leon Kircik, M.D., Icahn School of Medicine at Mount Sinai, New York.</p>")
“A better understanding of acne pathophysiology and the role of inflammation has … yielded a better understanding of how existing therapies treat the disease and have led to more comprehensive treatment strategies that are multitargeted," says Leon Kircik, M.D., Icahn School of Medicine at Mount Sinai, New York.
Systemic antiandrogens and hormonal modulation are already used to treat acne successful in some women, but there are concerns about systemic exposure.11 As clascoterone is applied topically and acts locally on androgen receptors in the skin, no systemic exposure has been seen and preliminary data from phase 2 trials suggest it has the potential to be an effective and a well-tolerated treatment.12
Researchers have found that cannabidiol (CBD), one of the 113 cannabinoids identified from Cannabis sativa, has anti-inflammatory properties which can prevent the proliferation of sebocytes,13 inhibit human keratinocyte proliferation14 and to possess potent antimicrobial activity against Gram-positive bacteria such as C. acnes.15
MORE ON ACNE: Read more stories here.
A synthetic cannabidiol topical formulation, BTX 1503, is being tested in acne, Dr Kircik says.
“Early clinical data confirm both the anti-inflammatory effects of topical BTX 1503 as well as its effects on noninflammatory lesions, with 4-week reductions in inflammatory lesion counts similar to what are reported in clinical trials for leading FDA-approved topical therapies in the same time frame,” he says.
1. Kircik LH. What's new in the management of acne vulgaris. Cutis. 2019;104(1):48-52.
2. Kang S, Cho S, Chung JH, Hammerberg C, Fisher GJ, Voorhees JJ. Inflammation and extracellular matrix degradation mediated by activated transcription factors nuclear factor-kappaB and activator protein-1 in inflammatory acne lesions in vivo. Am J Pathol. 2005;166(6):1691-9.
3. Leyden JJ, Sniukiene V, Berk DR, Kaoukhov A. Efficacy and Safety of Sarecycline, a Novel, Once-Daily, Narrow Spectrum Antibiotic for the Treatment of Moderate to Severe Facial Acne Vulgaris: Results of a Phase 2, Dose-Ranging Study. J Drugs Dermatol. 2018;17(3):333-338.
4. Lee YH, Liu G, Thiboutot DM, Leslie DL, Kirby JS. A retrospective analysis of the duration of oral antibiotic therapy for the treatment of acne among adolescents: investigating practice gaps and potential cost-savings. J Am Acad Dermatol. 2014;71(1):70-6.
5. Garner SE, Eady EA, Popescu C, Newton J, Li WA. Minocycline for acne vulgaris: efficacy and safety. Cochrane Database Syst Rev. 2003;(1):CD002086.
6. Jones TM, Ellman H, Devries T. Pharmacokinetic Comparison of Once-Daily Topical Minocycline Foam 4% vs Oral Minocycline for Moderate-to-Severe Acne. J Drugs Dermatol. 2017;16(10):1022-1028.
7. Raoof J, Hooper D, Moore A, et al. FMX101 4% topical minocycline foam for the treatment of moderate to severe acne vulgaris: efficacy and safety from a phase 3 randomized, double-blind, vehicle-controlled study. Poster presented at: 2018 Fall Clinical Dermatology Conference; October 18-21, 2018; Las Vegas, NV.
8. Gold LS, Del Rosso JQ, Bhatia ND, et al. Efficacy and safety of FMX103 (1.5% minocycline foam) in the treatment of moderate-to-severe papulopustular rosacea: results from two phase 3 randomized, multicenter,
double-blind, vehicle-controlled studies. Poster presented at: 2019 Winter Clinical Dermatology Conference; January 18-23; 2019; Koloa, HI.
9. Smith JA, Narahari S, Hill D, Feldman SR. Tazarotene foam, 0.1%, for the treatment of acne. Expert Opin Drug Saf. 2016;15(1):99-103.
10. Ju Q, Tao T, Hu T, Karadağ AS, Al-khuzaei S, Chen W. Sex hormones and acne. Clin Dermatol. 2017;35(2):130-137.
11. Barros B, Thiboutot D. Hormonal therapies for acne. Clin Dermatol. 2017;35(2):168-172.
12. Hebert A. Clascoterone topical cream, 1%: a novel, topical, local, selective androgen receptor antagonist: results from two phase 3 studies treating children and adult patients with facial acne vulgaris. Presented at: 2019 American Academy of Dermatology Annual Meeting; March 2, 2019; Washington, DC.
13. Oláh A, Tóth BI, Borbíró I, et al. Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. J Clin Invest. 2014;124(9):3713-24.
14. Wilkinson JD, Williamson EM. Cannabinoids inhibit human keratinocyte proliferation through a non-CB1/CB2 mechanism and have a potential therapeutic value in the treatment of psoriasis. J Dermatol Sci. 2007;45(2):87-92.
15. Appendino G, Gibbons S, Giana A, et al. Antibacterial cannabinoids from Cannabis sativa: a structure-activity study. J Nat Prod. 2008;71(8):1427-30.
