VIE
CLASCOTERONE 1% – A NEW OPTION FOR ACNE TREATMENT
The skin is one of the most important organs, protecting the body from external environmental factors, shaping our appearance, and serving as a sensory organ. However, when dry, the skin becomes rough, and may even crack, itch, and its functions can become impaired.
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Winlevi (clascoterone cream 1%) is a new acne treatment approved by the FDA in August 2020 based on the results of clinical trials. It is indicated for the treatment of acne in individuals aged 12 and older.
Clascoterone belongs to the androgen receptor inhibitor group of drugs. Clascoterone binds to androgen receptors in the sebaceous glands of hair follicles, reducing the effects of DHT (dihydrotestosterone) that increase sebum production and inflammation. This reduces sebum production and local inflammation. The approval of Winlevi is a breakthrough in acne treatment. This topical treatment provides an alternative to oral or topical antibiotics, benzoyl peroxide (BPO), adapalene, and tretinoin, which target bacteria. Clascoterone 1% inhibits the root cause of excessive sebum production—the oily environment that bacteria thrive in (C. acne). In clinical trials, Winlevi demonstrated effective reduction in inflammatory acne lesions and was well-tolerated when used twice a day, avoiding application to thin skin around the eyes, mouth, and mucous membranes.
Advantages of Winlevi (topical anti-androgen) over oral medications with similar mechanisms:
Oral anti-androgen medications for acne are typically prescribed as oral contraceptives (to reduce androgen production) or spironolactone (an androgen receptor inhibitor).
Although these oral medications are effective for treating acne resistant to oral antibiotics, they are not indicated for males due to side effects that cause feminization of certain body parts and affect reproductive function. In addition, they are contraindicated in pregnant women, and many women are reluctant to use oral medications that affect systemic hormones due to concerns about fertility and menstrual cycles.
On the other hand, topical clascoterone is metabolized into cortexolone when applied to the skin. Since it is applied to small areas, Winlevi only inhibits local androgen activity and has not been reported to cause systemic effects. Thus, clascoterone is recommended for use in both males and females. The most common localized skin reactions include mild erythema, itching, burning, or peeling of the skin.
If these side effects occur, consult your doctor for advice on adjusting application frequency or choosing alternative treatments. Inhibition of the hypothalamic-pituitary-adrenal (HPA) axis can occur during or after treatment with Winlevi. Factors that increase systemic absorption include application to large surface areas, prolonged use, and the use of occlusive dressings. Children are more susceptible to systemic toxicity (hence, the drug is only recommended for children aged 12 and older). Increased potassium levels (hyperkalemia) were observed in some subjects during clinical trials.
Current clinical trials primarily study the effectiveness and side effects of Winlevi during 12 weeks of use, and long-term data is still lacking. Therefore, Winlevi remains a promising treatment, but further long-term studies are needed to evaluate its beneficial effects, side effects, and combinations with other treatments in larger datasets. If you experience any abnormalities while using Winlevi, be sure to inform your doctor for proper guidance and treatment adjustments.
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