Adult acne risk factors clarified
Today's report also covers atrophic acne scars, topical clascoterone, laser treatments, and more (1,400 words, 6 minutes, 20 seconds)
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Good morning, and welcome to the 17th issue of Focus on Acne, presented by Skin Spectrum Weekly. This series provides up-to-date information on developing therapies and trends in acne treatment. We appreciate your feedback and suggestions and invite you to be in touch. Please write to us at health@chronicle.org
Adult acne risk factors clarified
Findings from a recent literature review (Health Science Reports April 30, 2025; 8(5):e70697) highlight that hyperandrogenism, a positive familial history, and a high-glycemic diet are linked to the development of adult acne. Understanding the pathogenesis of adult acne is crucial for effective treatment.
For the review, researchers made data searches on the PubMed and Scopus databases. Finally, 20 articles met the inclusion criteria.
The investigators found that several different hormones may be linked to the development of adult acne. Androgens play a particularly important role, as they can stimulate the growth of the sebaceous glands and increase the secretion of sebum, thus promoting the formation of skin changes associated with acne. A high glycemic diet increases the secretion of insulin, which in turn causes an increase in the amount of insulin-like growth factor (IGF)-1. IGF-1 increases the growth of the sebaceous gland, sebum production, and keratinocyte proliferation and activates androgen synthesis, thus contributing to acne pathogenesis. Adults with acne have a positive familial history more often than healthy controls, which indicates the genetic nature of adult acne.
Simultaneous acne, atrophic scar Tx safe, effective, efficient
Simultaneous treatment of acne and atrophic scars is clinically effective and safe. It also offers the advantages of shorter treatment duration and enhanced patient satisfaction, making it a promising therapeutic strategy.
This is the conclusion of a study published by Archives of Dermatological Research (April 29, 2025; 317(1):742).
The study authors write that while acne frequently coexists with atrophic scars, clinical management typically follows a stepwise approach. However, there is limited evidence on the efficacy of simultaneous treatment strategies for both conditions.
To address this gap, investigators conducted a prospective split-face controlled trial involving 30 patients with symmetrical bilateral facial acne lesions and atrophic scars.
Participants were treated on the right side of the face using a stepwise treatment, receiving 30% supramolecular salicylic acid for acne every two weeks for five sessions. Following the resolution of inflammatory lesions, physicians performed microneedling and subcision for atrophic scars once a month for three sessions. The left side received simultaneous treatment, with combined therapy (supramolecular salicylic acid, microneedling, and subcision) for both acne and atrophic scars once a month for three sessions.
Results demonstrated that the simultaneous treatment regimen was significantly more effective in reducing acne lesions than the stepwise approach (p<0.05). In contrast, both regimens showed comparable efficacy in improving atrophic scars (p>0.05). Researchers observed no significant adverse reactions in either group. Notably, the simultaneous treatment regimen significantly reduced the overall treatment duration and achieved higher patient satisfaction than the stepwise approach.
Topical clascoterone acne Tx also improves moisturization, skin barrier
In patients with acne-prone skin, twice-daily treatment with clascoterone cream 1% for two weeks was associated with increased moisturization and maintenance of skin barrier function as assessed by corneometry and trans-epidermal water loss (TEWL). The treatment was also otherwise well tolerated.
These findings were published in the Journal of Drugs in Dermatology (April 1, 2025; 24(4):397-402).
The study authors note topical medications commonly prescribed for the treatment of acne vulgaris may be limited by application-site dryness, which can result in skin barrier damage. They conducted a study to evaluate the effects of clascoterone cream 1% on skin barrier properties in acne-prone individuals.
For this single-centre, split-face study, researchers enrolled 50 participants 18 years of age or older who had acne-prone skin and randomized them to twice-daily treatment with clascoterone cream 1% (approximately 0.5 g) to the right or left side of the face for two weeks. The primary and secondary endpoints were the changes in corneometry reading and TEWL, respectively, between treated and untreated sides at week two. The investigators evaluated tolerability from the severity of dryness, erythema, scaling, irritation, tightness, stinging, itching, and burning for each side using a 5-point scale from 0 (none) to 4 (severe).
The mean ± standard deviation (SD) corneometry reading was significantly higher for the treated vs untreated side at week two (131.3±42.9 vs 113.9±; p<0.001). There was no difference in TEWL between treated and untreated sides at any time point assessed. All tolerability parameters evaluated were rated absent or minimal through week two for both sides.
1,064 nm laser tx has prolonged acne therapeutic effect vs. TXA
A head-to-head study of 1,064 nm long-pulsed Nd:YAG laser and intralesional tranexamic acid (TXA) as acne treatments shows both are effective and safe modalities, but the laser treatment had a prolonged therapeutic effect compared to the injections.
The findings were published in Archives of Dermatological Research (April 12, 2025; 317(1):709).
For this study, researchers included 30 patients with facial acne vulgaris in a prospective randomized split-face comparative study. Physicians treated each patient with long-pulsed Nd: YAG laser on one side, and intralesional TXA on the other at a two-week interval for four sessions. Researchers assessed each case through the Investigator Global Assessment of acne (IGA) scale, lesion counting, and erythema score at baseline, after the end of treatment, and after three months of follow-up.
Investigators found a statistically significant reduction in IGA, lesion count, and erythema score in both treated sides (p-value<0.001). Improvement of IGA and non-inflammatory lesion count was better in the laser-treated side than the TXA-treated side after treatment and follow-up (p<0.05). Improvement of inflammatory lesion count was non-significant on both sides after the end of treatment, while after follow-up, it was better on the laser side. Improvement of erythema score was non-significant between both therapy modalities after the end of treatment and follow-up.
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