What Dermatologists Learned From 52 Week Acne Data
Doctors who treat acne have gained fresh insights from studies tracking patients for a full year. These long-term trials reveal how certain treatments keep working over time while staying safe and easy to tolerate. One big lesson comes from research on clascoterone cream, a topical drug that blocks androgen receptors in the skin to cut down sebum production. Sebum is the oily substance that feeds acne-causing bacteria, so reducing it hits acne at its root.
In a key study led by Zoe Draelos, a dermatology expert from Duke University, 40 patients used clascoterone cream 1% twice a day for 52 weeks. Early results at 12 weeks showed a 27% drop in sebum levels, a 54% reduction in red inflamed pimples, and a 34% decrease in blackheads and whiteheads. These improvements held steady through the full year, proving the cream delivers lasting control without the irritation seen in many acne treatments. No peeling, dryness, redness, or swelling occurred, and patients reported little to no stinging or itching. This high tolerability helps people stick with the twice-daily routine, which is vital for real-world success.
Spironolactone, an oral hormone therapy often used for women with acne, also shone in 52-week data. The SAFA trial followed 410 women and found spironolactone led to big drops in acne severity at 12 and 24 weeks, with even better quality-of-life scores over time. By 52 weeks, far fewer patients needed oral antibiotics compared to placebo users: just 5.8% versus 13.5%. This suggests spironolactone can replace antibiotics long-term, avoiding resistance issues. Side effects were mild, like headaches or dizziness, and skin stayed stable with no major problems.
Another trial, FASCE, compared spironolactone to doxycycline in 133 women. Spironolactone at 150 mg daily outperformed the antibiotic after six months, with higher success rates on doctor-assessed scales. Doses around 100 to 150 mg worked best across studies, showing results in various acne types, including severe nodules.
These findings push dermatologists toward treatments that target hormones and sebum directly. They reduce reliance on antibiotics and offer options with fewer side effects, helping more patients clear their skin for good.
Sources
https://pmc.ncbi.nlm.nih.gov/articles/PMC12691598/
https://blogs.the-hospitalist.org/topics/acne
https://www.ajmc.com/view/the-tolerable-future-of-acne-treatment-reducing-sebum
https://jcadonline.com/pde4-inhibitor-responsive-dermatoses/
https://clinicaltrials.gov/study/NCT07261072
