Topical biofilm-disruptor shows promise for acne Tx
Topical biofilm-disruptor shows promise for acne Tx
Today's report also covers interactions of sarecycline and C. acnes, teledermatology follow-ups, RF microneedling, and more (1,400 words, 7 minutes, 40 seconds)
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Good morning and welcome to the first 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
Topical biofilm-disruptor shows promise for acne Tx
A six-month randomized, double-blind, controlled study has found that a biofilm-disrupting acne cream provides equivalent efficacy to 2.5% benzoyl peroxide (BPO) gel with fewer adverse effects.
The findings were published in The Journal of Clinical and Aesthetic Dermatology (April 2023; 16(4):43-52).
The study involved female subjects with mild-to-moderate acne treated daily with one of two formulations of a biofilm-disrupting acne cream containing salicylic acid (known as 1x and 2x), a formulation of the cream without salicylic acid, 2.5% BPO gel, or a placebo. Subjects applied the assigned product to their face twice daily and were evaluated for clinical acne and quality of life outcomes at baseline and after six, 12, 18, and 24 weeks of treatment.
After 24 weeks of use, subjects treated with biofilm-disrupting acne cream 2x had a significantly greater improvement in the Investigator Global Assessment (IGA), compared to those treated with 2.5% BPO gel. Additionally, biofilm-disrupting acne cream 2x, biofilm-disrupting acne cream 1x, biofilm-disrupting acne cream without salicylic acid, and placebo control were associated with less erythema and dryness, compared to 2.5% BPO gel. However, the study’s assessments had the potential for subjective differences due to variability between evaluators.
Overall, the biofilm-disrupting acne cream 2x and biofilm-disrupting acne cream 1x provided equivalent efficacy to 2.5% BPO gel with fewer adverse effects, while the biofilm-disrupting acne cream without salicylic acid and placebo control were associated with mild improvements to acne symptoms over the course of the 24-week study.
Unique interactions of sarecycline and C. acnes identified
A new study has identified how the third-generation tetracycline antibiotic sarecycline has a strong specificity for C. acnes while also seeming to have a low risk of encouraging antibiotic resistance.
Published in Nucleic Acids Research (April 11, 2023; 51(6):2915-2930), the study describes how researchers visualized the C. acnes ribosome and how sarecycline interacts with it.
“This is a huge step in the right direction towards pathogen-specific antibiotic development,” said the study’s principal investigator Christopher Bunick, MD, PhD, in a press release. “If we can understand sarecycline’s low propensity for antibiotic resistance in C. acnes, that allows for the future development of even more targeted and safer antibiotics or other medicines with minimal resistance risk.”
Dr. Bunick is an associate professor of dermatology at the Yale School of Medicine in New Haven, Conn.
The investigation revealed that, unlike other antibiotics, sarecycline is bound to not one, but two active sites on the ribosome. Earlier studies of sarecycline in the model ribosome of the bacteria Thermus thermophilus found only one binding site.
The authors write that the second binding site is similar to one that interacts with the macrolides class of antibiotics.
According to the release, these findings are important for two reasons. First, this is the first group to visualize the structure of the C. acnes ribosome itself and make several observations. C. acnes ribosomes have proteins with zinc-free and zinc-bound isoforms. Some dermatology research suggests that zinc supplementation might help treat acne vulgaris and support antibiotic treatments. This work further supports that zinc supplementation may help treat acne.
Second, the model explains why sarecycline use is less likely to lead to antibiotic-resistant mutations.
“The probability of having a mutation at one ribosomal site is high, but the probability of having mutations at two sites at the same time is much lower,” said the paper’s lead author Ivan Lomakin, PhD, an associate research scientist in dermatology at Yale.
Teledermatology for acne follow-up reduces patient burden
A randomized clinical trial published in Acta Informatica Medica (March 2023; 31(1):31-36) has found that teledermatology can provide effective follow-up for patients with mild-to-moderate acne.
The study, which compared teledermatology versus face-to-face consultation in 24 patients with acne vulgaris, found that while the cumulative time spent by the physician was higher in the teledermatology group, the cumulative time spent by the patient was significantly lower.
Both groups showed optimal reduction of acne severity, without significant differences between them. Patient satisfaction did not change significantly over time and between groups and was generally high. Adverse events were reported by one patient in the teledermatology group and four patients in the consultation group.
The study concludes that teledermatology could be an optimal approach for following up with patients with acne because it can reduce the burden on patients and medical staff. However, the implementation of more user-friendly platforms is necessary to achieve the best possible results in the treatment and follow-up of acne patients.
RF microneedling/isotretinoin combination results in faster, longer-lasting acne improvement
New findings suggest that combining isotretinoin acne treatment with radiofrequency (RF) microneedling is safe and effective, has a quicker response, causes less scarring, and reduces recurrence compared to isotretinoin alone.
The cross-sectional study, published in Postępy Dermatologii i Alergologii (Feb. 2023; 40(1):111-114) compared the effectiveness and safety of an automated RF microneedling device and oral isotretinoin to isotretinoin alone for treating active acne. The study included 40 moderate acne patients who were divided into two groups: Group A, which included 20 patients treated with an automated RF microneedling device and isotretinoin 0.5-1 mg/kg, and Group B, which included 20 patients who were given a single dose of 0.5-1 mg/kg isotretinoin.
Researchers found that after 12 weeks, Group A showed better global acne assessment scale (GAAS) outcomes than Group B, and after six months, Group A showed better results than Group B. The GAAS did not change after four to eight weeks of treatment, and there were no differences in age or weight between the two groups.
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