Topical Acne Therapies: A Clinical Update

Julie C. Harper, MD

Photo courtesy of dermsquared

Julie C. Harper, MD, of the Dermatology and Skin Care Center of Birmingham in Birmingham, Alabama, spoke at the 2025 Winter Clinical Dermatology Conference about insightful details regarding selecting among topical acne treatments, providing clinicians with data-driven pearls to better care for their patients.

Triple Combination Therapy Demonstrates Strong Efficacy

One of the most fascinating findings presented was the efficacy of a triple-combination clindamycin phosphate 1.2%, adapalene 0.15%, and benzoyl peroxide 3.1% topical gel. Results from two phase 3 randomized, double-blind trials over 12 weeks (N=363) indicated that more than 50% of patients achieved clear or near-clear skin with a 70% reduction in lesion counts. This combination was superior to adapalene 0.3%/benzoyl peroxide 2.5% gel and other standard preparations in lessening lesions.

Clascoterone: First Topical Antiandrogen

Harper also discussed the unique benefits of clascoterone 1% cream, the first topical antiandrogen for the treatment of acne. Results from two 12-week, randomized, double-blind, vehicle-controlled trials (N=1440) showed statistically significant reductions in inflammatory lesion counts in moderate-to-severe acne. Few treatment-emergent adverse effects included application site erythema and dryness, the most common.

Trifarotene for Acne Scarring and Hyperpigmentation

The effectiveness of trifarotene 0.005% cream for atrophic acne scar therapy was another high point. A split-face, double-blind, randomized study (N=121) supported the finding of a 54% reduction in scar depth after 24 weeks. Apart from that, its application in treating post-inflammatory hyperpigmentation was discussed, further cementing its status as an all-around retinoid treatment.

Tazarotene 0.045% Lotion: Enhanced Tolerability with Effective Results

The latest news on tazarotene 0.045% lotion emphasized its new polymeric emulsion technology, which has been optimized to enhance drug delivery and tolerability. The product was found to be as effective as tazarotene 0.1% cream with reduced irritation, thus a more patient-tolerable therapy for moderate-to-severe acne.

Clinical Implications

The presentation highlighted the growing individualization of acne treatment, with greater focus on combination therapy, novel delivery systems, and targeted agents such as clascoterone. These developments offer dermatologists more effective and better-tolerated treatments for patients at all levels of acne severity.