Hilary Baldwin, MD, Highlights Emerging Acne and Rosacea Therapies at Elevate-Derm

There are some exciting new options in the pipeline for acne and rosacea, Hilary Baldwin, MD, told Dermatology Times at the 2025 Elevate-Derm Fall Conference. “And interestingly, I think the rosacea pipeline is a little bit richer right now than the acne pipeline, which is completely different than usual,” she added.¹

Sponge-Derived Therapy Shows Multifunctional Activity

One of the more unusual acne agents in development is a freshwater sponge–derived compound from Spongilla, explained Baldwin, medical director of the Acne Treatment and Research Center in Brooklyn, New York. She described Spongilla looking “sort of like a sponge monster,” noting its green spicules and distinct physical and biochemical effects. The spicules helped “to unroof the comedones, to increase the penetration of things with which they're co applied,” she said. The active agent appears to offer antibiotic, anti-inflammatory, and IL-17–targeted activity.

Dermata Therapeutics, Inc successfully completed its phase 3 program of Xyngari, although she said full data has not been released. Baldwin added that phase 2 findings were “highly statistically significant,” generating considerable interest.²

Sebum-Targeted Pathways Advance in Late-Stage Trials

Baldwin shared news about another late-stage candidate, Ascletis Pharma Inc.’s ASC40, which acts as a farnesyltransferase inhibitor to reduce sebum production. Because excess sebum remains foundational in acne pathophysiology, Baldwin emphasized the importance of this approach. “They just released their phase 3 data from one study done in China, 480 patients, with really good results in terms of lesion count reduction and IGA improvement” she told Dermatology Times.³

Early Vaccine and Microbiome Research Expands

Baldwin also highlighted work on a potential acne vaccine. “It's a therapeutic vaccine, not an immunization against the disease,” Baldwin explained. “This is not a vaccine that you would take in order not to get acne, but rather to stop your acne from becoming severe once it's already moderate.” The phase 1 study has concluded, but results had yet to be released, she added.

Maybe combine that with a bacteriophage, which sets out to kill the type of C acnes most commonly associated with acne, put them together in one cream and rub bacteria and viruses all over your face to reduce your acne. Sounds a little gross, but it may actually be part of the future of acne therapy.

Another promising treatment direction includes microbiome-directed therapies, using targeted probiotics, prebiotics, or bacteriophages. Baldwin explained potential strategies to increase health-associated C. acnes strains while reducing acne-promoting strains. “Maybe combine that with a bacteriophage, which sets out to kill the type of C acnes most commonly associated with acne, put them together in one cream and rub bacteria and viruses all over your face to reduce your acne. Sounds a little gross, but it may actually be part of the future of acne therapy,” she said.

Rosacea Pipeline Explores Narrow-Spectrum and Mast Cell Targets

For rosacea, Baldwin pointed to sarecycline (Seysara), which “was taken out for a small clinical spin” and appeared effective. “We don't really want to utilize full dose antibiotics for a condition which is inflammatory and noninfectious, but if you need to turn to full dose antibiotics among the tetracyclines, sarecycline is the most narrow spectrum and least likely to cause problems with the gut.”

She also highlighted emerging interest in mast cell inhibition. Mast cells were “highly involved in the pathophysiology of rosacea,” Baldwin noted, but effective mechanisms to reduce mast cell number, chemotaxis, or degranulation were still lacking. Several agents were exploring this pathway.

Novel Pathways and Innovative Treatments

Baldwin emphasized that research and the pipeline hold promise for clinicians and their patients with acne and rosacea. “I think the future is bright for both acne and rosacea, and I am looking forward to what they come up with next.”

Discover more highlights from the Elevate-Derm Fall Conference.

References

1. Baldwin H. Inflammatory Pathways in Acne & Rosacea. Presented at the 2025 Elevate-Derm Fall Conference; November 12-16, 2025; Tampa, California.

2. Andrus E. Topical Xyngari Meets All Primary Endpoints in Phase 3 Study for Moderate to Severe Acne. Dermatology Times. March 27 ,2025. Accessed November 14, 2025.

3. Zeichner J, Bosslett. From COVID-19 to Clear Skin: How mRNA Technology May Be Used to Fight Acne. Dermatology Times. August 25, 2025. https://www.dermatologytimes.com/view/from-covid-19-to-clear-skin-how-mrna-technology-may-be-used-to-fight-acne