2024 In Review: This Year's Trends in Dermatology

Peter Lio, MD

What’s Hot: Atopic dermatitis (AD) is super-hot right now! We are in the midst of a flurry of new approvals, both topical and systemic, with a pipeline that rivals that of psoriasis after a long period of drought.

Doris Day MD, FAAD

What’s Hot: A focus on regenerative and longevity beauty; that is, beauty that goes more than skin deep, is longer lasting, and appears more natural and authentic. Additionally, menopause: There is a great and long-overdue focus on the hormonal changes that begin around the 40s for most women. They are now getting better guidance on hormone replacement therapy (HRT) and also treatments that are especially useful for this stage of life, to make them your most beautiful years yet.

What’s Not: There are some devices I was really looking forward to, like the ellacor® System with Micro-Coring® technology, that I still think are very interesting technologies, but they don’t seem to have measured up to the expectations they set. I’m continuing to follow and have an open mind to next-generation devices in the category.

Julie C. Harper, MD, FAAD

What Was Hot: The discussion surrounding the safety of benzoyl peroxide continues and may literally be hot, with higher temperatures and ultraviolet exposure correlating to benzene production. This is a fluid topic that remains unresolved.  

What Was Not: Including cost as a determinant of recommendation for acne medications in the American Academy of Dermatology (AAD) Guidelines was a miss that may have a long-lasting impact on innovation for our acne patients. The products that had the highest quality data were relegated to “conditional recommendation” based on a subjective judgment on cost. The costs of these drugs compare quite favorably to other new entries into the dermatology space, including JAK inhibitors and biologics.  

New Approval That Lived Up to the Hype: Cabtreo. The first-ever topical, fixed-dose triple combination has lived up to the hype. It delivers efficacy and tolerability and is easy and convenient.

Natasha Atanaskova Mesinkovska, MD, PhD

What’s Hot: GLP-1 and skin improvement!

What’s Not: Exosomes!

Cheri N. Frey, MD, FAAD

What’s Hot: Novel mechanisms to treat hyperpigmentation, such as Melasyl, which degrades melanin precursors, and Thiamidol—although it will not be released in the US until 2025, there’s much buzz around this ingredient as it is a human tyrosinase inhibitor. Additionally, the science of aging—specifically inflammaging, cellular senescence, and prejuvenation—is hot, as well as improving skin quality via skin boosters and topical estrogen.

What’s Not: Hydroquinone and skin bleaching in general; biotin for hair loss; and overfilled lips and tear troughs. 

Jashin J. Wu, MD, FAAD

What’s Hot: Newly approved therapies or new indications/younger ages in psoriasis—bimekizumab, tapinarof cream, roflumilast cream, spesolimab.

What’s Not: Uptake/utilization of biosimilars for psoriasis.

Brad P. Glick, DO, MPH, FAAD

What’s Hot: Hidradenitis suppurativa (HS) in medical dermatology, with new therapeutics involving IL-17A/IL-17A/F, and JAKs. Chronic spontaneous urticaria (CSU) is making her comeback in dermatology, with dupilumab and remibrutinib showing promising study results. There is a major pipeline for topicals including JAK inhibitors and PDE-4 inhibitors. 

What’s Not: Topical steroids and topical calcineurin inhibitors—nothing is in the pipeline, and they are being used less than less. Nonsteroidal topicals are part of the new treatment paradigm for inflammatory skin diseases.

Collin Blattner, DO, FAAD

What’s Hot: JAK inhibitors for alopecia areata and AD, GLP-1 prescriptions written by dermatologists, novel BTK inhibitors for chronic spontaneous urticaria, oral IL-23 inhibitors for psoriasis, and Castle Biosciences’ DecisionDx-SCC test for high-risk squamous cell carcinoma.

What’s Not: Old therapeutics like methotrexate, CellCept, and cyclosporine. Also, the Dermtech Melanoma Test.

Joel L. Cohen, MD, FAAD

What’s Hot: Combination rejuvenation approaches, such as RF microneedling and resurfacing in combination. 

H.L. Greenberg, MD

What’s Hot: Exosomes! We are using them with microneedling and post-ablative procedures instead of platelet-rich plasma (PRP) because it doesn’t require a blood draw.

Also, the Gentlemen of Dermatology Society got its start in 2024 and is open to both gentlemen and lady members with membership categories, similar to the Women of Dermatology Society.

Raj Chovatiya, MD, PhD, MSCI, FAAD

What’s Hot: Does disease modification exist in AD? Is remission a real possibility? Do any of our current treatment options help to answer these questions?? These were the questions swirling around the AD disease space in 2024. While no clear answer has emerged, there is a clear eye to the future with emerging therapies that are attempting to more directly answer this question.

E. Victor Ross, MD, FAAD

What’s Hot: Some of the hot issues would be laser coring with 2910 nm, continued advances in the Tixel technology, and continued advances in tweaking and optimization of RF microneedling.  We have found in our recent studies that laser coring with smaller wounds (270 µm in diameter vs 350 µm) tends to achieve as good a result but with less likelihood of persistent dots on the skin. And Tixel, a pyramidal titanium fractional technology, seems to be a good fit between very heavy procedures and very light procedures as far as optimizing results and limiting downtime. Finally, our latest research shows that using longer pulses and more energy invested (per pulse) with RF microneedles, although it hurts more, most likely provides better results and improved tissue tightening vs shorter, less energetic pulses.

Todd Schlesinger, MD

What’s Hot: Biologics for HS and psoriatic arthritis, oral biologics, intralesional biologics/checkpoint inhibitors and photodynamic therapy (PDT) for skin cancer, RNA and DNA therapeutics, and tirbanibulin for actinic keratosis. Additionally, off-face/scalp PDT and field actinic keratosis therapy (tirbanibulin). 

What’s Not: Copycat energy-based devices, expensive equipment warranties, and Medicare reimbursement. 

What’s Emerging But Still Unknown: Exosomes, genetic expression profiling for medical dermatology.

Corey L. Hartman, MD, FAAD

What’s Hot: Regenerative medicine, autologous stem cells, microcoring, platelet-derived growth factors, JAK inhibitors for vitiligo, and dermatologists in private practice.

What’s Not: Exosomes, private equity, and radiofrequency.

Daniel Schlessinger, MD, FAAD

What’s Hot: BBL HEROic is a new form of intense pulsed light (IPL) that is a real engineering improvement in the way IPL is delivered for more consistent results. Also, a continued emphasis on physical blockers over chemical sunscreens for safety and environmental reasons, and hypochlorous acid and sodium hypochlorite for acne and cleansers.

What’s Not: Although 2023 brought huge amounts of hype around large language models (AI chatbots) after the release of ChatGPT, 2024 tempered expectations as consumers discovered practical drawbacks limiting daily use. Also, more data showing that benzoyl peroxide may be converted into carcinogenic benzene when stored at a certain temperature has limited its use. Skincare trends such as double cleansing and skin cycling also became “old news” in 2024.

Ava Shamban, MD, FAAD

What’s Hot: What exactly is precision nanomedicine, and how does it apply to dermatology? Also, the biological effects of toxin on rosacea, psoriasis, pores, etc., and the long-term effects of fillers on the skin and fat pads—what is the downside to early vs. late intervention of these procedures? Additionally, the medical effects of laser treatments.

What’s Not: Everything else—just kidding! I’m so interested in the biologics.

James M. Ulery, MD, FAAD

What’s Hot: New-generation topical medications that are nonsteroidal and cross over between psoriasis and AD with surprising efficacy, such as tapinarof and roflumilast. Also, mineral-based sunscreens in water-based formulations (light lotion) that men will actually use.

What’s Not: Excimer laser for psoriasis or light therapy in general.

Some Interesting Ideas: Deucravacitinib for lupus, field therapy of 5-fluorouracil (5-FU) with calcipotriene for 5 to 10 days.

Adam Friedman, MD, FAAD

What’s Hot: In addition to what others have mentioned, sensitive skin syndrome—defining and managing a distinct medical condition, pruritus of unknown origin. Also, off-label JAK inhibitors (scarring alopecias, lichen planus, granulomatous diseases), geriatric dermatology, and immune drift (biologics inducing other inflammatory skin conditions like “psoriasiform” but not psoriasiform dermatitis of TNF inhibitors).

What’s Not: TikTok dances? Topical minoxidil (I don’t care what that study suggested—low-dose oral minoxidil is absolutely more effective then topical), and lab monitoring for isotretinoin and terbinafine. n

-Compiled by Jason Mazda