Advances in Acne Treatment: 2024 Highlights and What to Watch for in 2025

In this episode of Topical Conversations, Dr John Barbieri of Brigham and Women’s Hospital in Boston provides an overview of the exciting developments in acne treatment in 2024 and shares key innovations to look forward to in 2025. 

2024: a year of breakthroughs in acne care 

Fixed-dose combination therapy 

One of the standout advancements of 2024 was the introduction of a fixed-dose combination therapy comprising clindamycin, adapalene, and benzoyl peroxide. Dr. Barbieri highlights this as the most efficacious single-agent topical treatment currently available for acne. 

• Optimized vehicle: Unlike other products, this combination utilizes an advanced formulation to minimize irritation and improve patient comfort. 
• Enhanced adherence and outcomes: Studies comparing fixed-dose combinations to separately used components have demonstrated improved adherence rates and superior clinical outcomes. 
• Comprehensive mechanism of action: Pairing this fixed-dose therapy with another agent, such as clascoterone, addresses all major acne pathways, offering a robust, well-tolerated treatment option. 

1726 nm lasers: targeted sebaceous gland therapy 

Another significant development in 2024 is the emergence of 1726 nanometer lasers, including devices like AviClear and Accure. 

• Precision treatment: These lasers directly target sebaceous glands, providing a focused alternative to systemic therapies like isotretinoin, which often carry off-target side effects such as eye dryness and systemic impacts. 
• Clinical efficacy: Clinical trials show promising results: 
  • Around 40% of patients with moderate to severe acne achieve clear or almost clear skin for up to 6 months post-treatment. 
  • Eighty to 90% of patients experience at least a 50% reduction in inflammatory lesions. 
• Well-tolerated option: While transient acne worsening can occur, the overall side effect profile is favorable, offering a new avenue for patients who cannot or prefer not to use systemic treatments. 

Looking ahead: innovations in 2025 and beyond 

Spongilla lacustris extract mask 

A topical treatment derived from Spongilla lacustris extract is under development as a once-weekly mask with dual anti-inflammatory and antimicrobial properties. 

• Phase 2 success: Early trials have shown promise, paving the way for this novel therapy to become an accessible option for patients with acne 

N-acetyl-GED 

Another exciting candidate is a topical treatment targeting the sebaceous glands. 

• Direct Action on Sebaceous Glands: This innovation offers a rare mechanism of action for topical therapies, focusing on reducing sebum production, oiliness, and acne-promoting factors like C. acnes bacteria 
• Potential for Impact: With few existing treatments addressing sebaceous gland activity directly, this agent holds potential to reshape acne management 

The Road Ahead in Acne Treatment 

As we look ahead to 2025, the landscape of acne treatment is set to evolve with a mix of innovative therapies and technologies. Fixed-dose combination topicals, advanced laser technologies, and novel agents in development offer new options to address the complex mechanisms of acne. These advancements provide dermatologists with more tools to tailor treatments to individual patient needs. 

By staying informed and incorporating these developments into practice, dermatologists can continue to refine their approach to managing acne and improve overall outcomes.