New Drug Developments in Acne

During the last 25 years, we have reached an impressive increment of knowledge about the pathophysiology of acne. However, the progress of developing effective and tolerable new drugs for the topical or systemic route is far behind modern understanding of acne management. Only a few major efforts have been undertaken to introduce new therapeutic regiments optimizing toward an ideal treatment of acne. The current situation of increasing emergence of microbial resistance associated with antibiotics has led to the question of using antibiotics in acne at all. The highly effective class of retinoids is associated with teratogenic adverse events, particularly associated with systemic isotretinoin, but will improve with new classes of topical retinoids. Whether an improved adverse drug profile with better local and systemic tolerability can be reached is still a matter of debates. Almost all medical compounds with delivery via the topical or systemic route have an adverse profile. The benefit/risk ratio and cost/efficacy balance have always to be calculated.