Oral Sarecycline for Treatment of Papulopustular Rosacea: Results of a Pilot Study of Effectiveness and Safety.

BACKGROUND: Cutaneous rosacea is a common inflammatory skin disorder that often presents with facial papulopustular lesions that are frequently bothersome to patients. Studies have shown oral sarecycline to be effective and safe for acne, with a low risk of side effects that are historically associated with other tetracycline-class drugs such as doxycycline and minocycline, in addition to offering a reduced risk of emergence of resistant bacteria due to its narrow-spectrum of antibiotic activity. Oral sarecycline is FDA-approved for the treatment of acne (2018). OBJECTIVE: A pilot study to evaluate the efficacy and safety of oral sarecycline in papulopustular rosacea. METHODS: A 12-week, prospective, parallel-group, investigator-blinded, controlled pilot study was completed evaluating once-daily sarecycline, using weight-based oral dosing as recommended for acne vs control (multivitamin tablet), for the treatment of moderate-to-severe papulopustular rosacea in adult subjects (n=102), aged ≥18 years. The primary efficacy endpoint was Investigator's Global score (IGA; clear or almost clear) and percent reduction in inflammatory lesion count at week 12. Safety and tolerability assessments were performed as well. RESULTS: A total of 102 subjects were randomized; 97 completed the study. At week 12, IGA improvement was significantly greater for oral sarecycline when compared to the control (P<0.0001). Furthermore, absolute and percent reductions in inflammatory lesion counts were significantly greater in the sarecycline group for all weeks (4, 8, and 12) when compared to the control (P<0.001). Significant improvement in facial burning, erythema, and pruritus was reported in the sarecycline group, when compared to the control (P<0.05). No serious AEs were reported. CONCLUSION: Sarecycline was effective, safe, and well-tolerated for treating papulopustular rosacea in adults with marked superiority in efficacy compared to subjects in the control group. With its narrow-spectrum activity, oral sarecycline may be a good option for the treatment of papulopustular rosacea. Additional studies are warranted to confirm the positive results of this pilot study.

The use of fillers and botulinum toxin type A in combination with superficial glycolic acid (alpha-hydroxy acid) peels: optimizing injection therapy with the skin-smoothing properties of peels.

There are many procedures that a physician may utilize to improve the appearance and quality of the skin. Combining procedures can enhance the overall result and lead to increased patient satisfaction. Thus, it is important to choose procedures that will complement each other. Fillers or botulinum toxin type A (BTX-A) can plump the skin and smooth lines and wrinkles but will do little for uneven tone, skin laxity, or radiance and clarity. These signs of aging can be addressed with superficial glycolic acid peels. Methods of combining injectable compounds with superficial glycolic acid peels were discussed at a dermatologist roundtable event and are summarized in this article.

Enhancing cosmetic outcomes by combining superficial glycolic acid (alpha-hydroxy acid) peels with nonablative lasers, intense pulsed light, and trichloroacetic acid peels.

Nonablative lasers, intense pulsed light (IPL), and trichloroacetic acid (TCA) peels are cosmetic rejuvenation techniques used to remodel skin and provide improved skin texture, firmness, and even pigmentation. Glycolic acid is an alpha-hydroxy acid that can be used as a topical skin peel to provide important complementary benefits to nonablative lasers, IPL, and TCA peels. Superficial glycolic acid peels provide both epidermal and dermal antiaging benefits, can be used to smooth the stratum corneum to reduce light scattering, and can enable the use of lower concentrations of TCA during a peel procedure. When used with these procedures, glycolic acid peels can enhance skin benefits and perceived patient outcomes. Methods of combining nonablative lasers, IPL, and TCA peels with glycolic acid peels were discussed at a dermatologist roundtable event and are summarized in this article.