Photo: LBPics (Wikimedia Commons)

If you survived adolescence without a harrowing bout of acne, consider yourself lucky: It’s estimated that 85 percent of people aged 12 to 24 have had at least mild acne. But if you’re among those of us who would have been thrilled to deal with merely “mild” acne, you’ve probably tried a number of different products to fight the throbbing pus mountains, many of which likely introduced new problems and side effects altogether.

The creators of a new anti-acne cream claim their experimental treatment clears zits better than some over-the-counter products, without any aggressive side effects. It works by preventing inflammation, as opposed to traditional treatments like salicylic acid and benzoyl peroxide, which primarily work by increasing the shedding of dead skin cells and killing bacteria, respectively. Both salicylic acid and benzoyl peroxide are effective treatments for many people, but they can cause dry, red, or irritated skin.

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“We aren’t just waving our hands and saying, ‘It works!’” said Eduardo Perez, chief scientific officer at Signum Biosciences, the company behind the cream. “We know the mechanism and demonstrate that it works.”

Acne forms when hair follicles get clogged with dead skin cells and the oily sebum that our skin naturally produces. Bacteria called Cutibacterium acnes (formerly referred to as Propionibacterium acnes) digest that excess oil and bump into receptors on the cells there that trigger inflammation—that’s the mechanism responsible for your red, angry pimples.

Most treatments today fight acne by killing bacteria, reducing oil production, or clearing out pores by encouraging dead skin cells to shed faster. But this new compound, called SIG1459, not only kills C. acnes but also reduces inflammation by blocking the receptors from calling in inflammatory responders. That keeps skin calmer and less aggravated.

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“It’s an exciting thing to get another medication with a different mechanism of action,” Marc Glashofer, a dermatologist at an independent practice in New Jersey who wasn’t involved in developing the new cream, told Gizmodo. “It’s not just another rebranded retinoid.”

“Acne really is an inflammatory process,” Glashofer added. “And if there’s a medication that can decrease inflammation while also providing antibacterial properties, that’s awesome.”

So far, SIG1459 hasn’t shown any dramatic side effects, so it might be an attractive option for those who have been suffering at the hand of benzoyl peroxide or oral antibiotics. While both can be effective for clearing up acne, the former often causes skin irritation and flaking, and the latter can alter the microbiome, which sometimes induces a slew of other adverse health effects.

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But though the new compound hasn’t been linked to unpleasant side effects yet, more research is needed. “It’s a new pathway, so we don’t fully know all the potential side effects that can occur,” Glashofer said. “With anything you apply, there are risks.”

In a small clinical trial published recently in Experimental Dermatology, SIG1459 cream was more effective than benzoyl peroxide for clearing up acne. For eight weeks, 35 people applied SIG1459 twice daily, while 15 people applied benzoyl peroxide twice daily. The SIG1459 users had an average reduction in acne severity of 77 percent, while the benzoyl peroxide users saw an average reduction in acne of 56 percent. An unlucky group of 15 people who received an inactive placebo cream saw their acne worsen by 30 percent.

Since this is a small study of fewer than 100 subjects, it’s far from conclusive evidence that SIG1459 is ready to replace existing, proven acne treatments. Perez said he’d like to repeat the experiment with larger groups and compare it to other acne treatments to nail down the drug’s efficacy. What’s more, the trial participants used benzoyl peroxide at a concentration of 3 percent; Joel Cohen, a dermatologist and director of AboutSkin Dermatology in Colorado, told Gizmodo that benzoyl peroxide is often used at a higher concentration than that. However, higher concentrations tend to be even more irritating to skin.

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And while SIG1459 is seems effective at fighting inflamed pimples—which would theoretically include hormonal and cystic acne—there’s no guarantee that it would work for everyone. One study participant didn’t see any improvement in their skin while using the new product. Perez also said the team is unsure whether the new product could combat other skin issues, like wrinkles, post-pimple hyperpigmentation, or even blackheads.

Still, Cohen, who is not affiliated with Signum Biosciences, said this new cream could have a place in the acne-fighting toolbox. “We certainly would welcome another topical product in our armamentarium of trying to treat and combat acne,” he told Gizmodo. “Our approach to acne as dermatologists involves multiple different products and treatment regimens.”

In fact, it could be a perfect partner to a retinoid, Glashofer said. Retinoids increase cell turnover to unclog pores and reduce oil production, while SIG1459 could hit the antibacterial and anti-inflammatory angles.

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Signum Biosciences is not currently planning to seek Food and Drug Administration approval for SIG1459, Perez said, which likely means any product containing the compound will not be explicitly marketed as an acne treatment (since acne is considered a disease by the FDA). Perez said a SIG1459 cream should be available over the counter in the first half of 2019.

[Experimental Dermatology via New Scientist]