Hormonal Acne? A New Topical Treatment That Targets the Root Cause

For many people battling acne, finding the right treatment can be frustrating. From over-the-counter cleansers to prescription medications, options often come with trade-offs, some may be too drying, others don’t target the root cause, and many require long-term use to see consistent results. A breakthrough topical treatment called clascoterone cream 1% works differently. In August 2020, the FDA approved it for treating acne in people aged 12 and older and it is the first FDA-approved topical androgen receptor inhibitor for acne.

How it works?

What sets clascoterone apart is its mechanism of action. While traditional acne treatments focus on unclogging pores, reducing bacteria (Cutibacterium acnes), or reducing inflammation, clascoterone works at the hormonal level. It blocks androgen receptors in the skin. Androgens are hormones that stimulate the sebaceous glands to produce oil (sebum). Excess oil can clog pores and lead to acne. Until now, anti-androgen therapy was only available in oral form, typically for women due to systemic side effects. Clascoterone fills a critical gap in acne management by offering hormonal control in a topical formulation, suitable for both males and females aged 12 and older. It has a lower likelihood of systemic side effects compared to oral hormonal therapies and demonstrates a favorable safety profile when used as prescribed.

The 4 main factors behind acne

To understand how this works, it’s helpful to know what causes acne. Acne vulgaris is driven by four main factors: excess sebum production, abnormal shedding of skin cells that clog pores, overgrowth of acne-causing bacteria, and inflammation. Clascoterone primarily targets the first and fourth causes, helping reduce oil production and lower inflammation.

How to use it and safety profile

Thin layer of clascoterone cream is typically applied to the affected area twice daily. A small, pea-sized amount is sufficient to cover most areas of concern. Apply it to clean, dry skin. It can be used alone or alongside other acne treatments, depending on your skin’s tolerance and your dermatologist’s advice. Patients may start to notice improvements within 8 to 12 weeks, though individual responses vary. Most people tolerate it well. The most common side effects include redness, dryness, flaking, itching, or a mild burning sensation. These are typically mild and temporary. In rare cases, slight changes in potassium levels or temporary hormonal effects may occur, particularly if the product is overused or applied to large areas of the body. However, these effects are uncommon and usually reversible upon discontinuation.

There are no absolute contraindications for clascoterone cream, but it is not yet approved for children under 12, and its safety has not been fully studied in pregnant or breastfeeding individuals. Therefore, patients in these groups should consult with their healthcare provider before using it. Additionally, caution is advised when combining clascoterone with other potentially irritating products, such as alpha hydroxy acids, salicylic acid, or alcohol-based solutions.

The cream is not approved for children under 12 and its safety is not fully known during pregnancy or breastfeeding. Therefore, patients in these groups should consult with their healthcare provider before using it. Additionally, caution is advised when combining clascoterone with other potentially irritating products, such as alpha hydroxy acids, salicylic acid, or alcohol-based solutions.

Is this right for you?

In summary, clascoterone cream is a promising option for acne. It treats hormonal causes of acne directly in the skin. It is the first of its kind and fills a gap between traditional creams and oral medications. It may be a great choice for people with persistent, oily, or hormonal-driven breakouts. If you’re struggling to control your acne and haven’t found success with other treatments, talk to your skincare provider to see if this treatment could work for you.