Acne is one of the most common diseases dermatologists encounter in daily practice. In this lecture, Julie C. Harper, MD, provided pearls on how to choose between the numerous topical acne treatments on the market. To begin, Dr Harper discussed a triple-combination topical recently approved to treat acne: clindamycin phosphate 1.2%, adapalene 0.15%, benzoyl peroxide 3.1% gel. In a Phase 3 study of patients 9 years and older, once-daily application of the triple-combination gel led to greater than 70% reduction in acne lesion count and over 50% of patients having clear or almost-clear skin at Week 12. When comparing efficacy data from Phase 3 study primary endpoints, the triple-combination gel outperformed all other combination topicals on the market as well as oral minocycline and sarecycline tablets. The triple-combination gel was well tolerated in clinical trials, with mostly mild burning and stinging that peaked at Week 2.

Moving on, Dr Harper reviewed data for clascoterone cream 1%, the first topical antiandrogen on the market for acne vulgaris, approved for both males and females. In a Phase 3 study of patients 9 years of age and older with moderate-to-severe acne, twice daily clascoterone cream 1% led to a 20% reduction in inflammatory lesion count at Week 12, compared to a 13% to 15% reduction for vehicle cream. In subsequent studies, clascoterone cream has been shown to reduce sebum amounts and has demonstrated stability when used with other acne medications such as tretinoin and benzoyl peroxide.

To conclude, Dr Harper discussed 2 novel topical retinoids: trifarotene 0.005% cream and tazarotene 0.045% lotion. In a randomized vehicle-controlled trial, trifarotene cream led to a 54% reduction from baseline in atrophic acne scars compared to 24% reduction with vehicle cream. Tazarotene 0.045% lotion is formulated with polymeric emulsion technology to promote uniform release and distribution of the active ingredient as well as humectant and hydrating ingredients. In pivotal studies, tazarotene 0.045% lotion demonstrated similar efficacy to tazarotene 0.1% cream, with considerably higher tolerability. With all of these topicals now available, it is a great time to treat acne.