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Acne and rosacea can have dramatic effects on quality of life, but new treatments and a robust pipeline are changing the trajectory for patients. Compared to older agents, novel treatments may offer better tolerability, which could lead to better adherence. J. Mark Jackson, MD, a clinical professor of medicine/dermatology at the University of Louisville in Louisville, KY and President of the American Acne and Rosacea Society (AARS), discusses where we are in acne and rosacea care, where we are headed, and why it matters for the millions of people who live with these skin conditions.

What are some of the latest advances in treating acne?

J. Mark Jackson, MD: There are some new retinoid agents that appear to be more effective on the comedonal component of acne without some of the irritation we have seen with previous retinoids. These new agents include trifaratone, micronized tretinoin lotion, and a new version of tazarotene.

A new topical anti-androgen—clascoterone cream 1%—is also an advance in the topical realm.

In terms of antibiotics, minocycline topical foam is now approved, and oral sarecycline has a narrower spectrum than the standard antibiotics we use to treat acne, which helps with antibiotic stewardship. We now have a better chance to get patients clear with new topical agents and to keep them clear before or after isotretinoin therapy. We can also prevent the long-term sequalae of scarring with acne if patients have access to dermatologic care and these therapies.

What are some of the latest advances in treating rosacea?

Dr. Jackson: We have the sub-antimicrobial dose doxycycline that is still being utilized, but if that is not effective, sarecycline may also have utility for rosacea and perioral dermatitis.

We have seen an increase in acne, rosacea, and perioral dermatitis with mask wearing over the last year. There are many drugs that target the erythema of rosacea, but there have been issues with access. Soolantra (topical ivermectin) cream has some remittive benefits, and we can give patients periods of clearance of disease with this agent.

How do acne and rosacea affect quality of life?

Dr. Jackson: First impressions matter, and acne and rosacea can take their toll on self confidence in employment and social situations and even affect a person’s hire ability. The latest survey from Sun Pharma, in collaboration with the AARS, showed that parents are very worried about the effects of severe acne on their teenagers for these same reasons. Ninety-three percent of respondents worry that severe acne will leave their children’s faces scarred, and 88 percent shared concern about the impact of severe acne on their child’s social life and mental health. Scarring is also permanent and disfiguring. It can and should be prevented via access to good care and the effective therapies.

What role can energy-based devices play in treating acne or rosacea?

Dr. Jackson: For rosacea, there are a lot of devices that help dilated vasculature and hypertrophic sebaceous glands. In acne, device-activated topicals that target the sebaceous glands are coming down the pike.

What’s in the acne and rosacea treatment pipeline?

Dr. Jackson: The pipeline is active. We are seeing new topical agents that target different cytokines in the inflammatory pathway of acne and rosacea and new non-antibiotic molecules.

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