Speaker Abstracts and Biographies

Acne Update: What’s New and What’s True

Mary Wu Chang (University of Connecticut School of Medicine)

Acne is the most common skin condition in the United States, affecting up to 50 million Americans annually Approximately 85% of people between the ages of 12 and 24 have acne Adult acne is increasing, and now affects up to 15 percent of women This talk will begin with a look at different types of acne and review the medications in the der matologist's ar mamentarium

n Mary Wu Chang, M.D.

Dr Chang is a board-certified dermatologist and pediatric dermatologist with over 26 years ' experience. After graduating from University of W isconsin School of Medicine and Public Health, she went on to complete a pediatrics residency at Kaiser San Francisco followed by a der matology residency at Wayne State University she served as Chief Resident for both residencies Dr Chang then joined the full-time faculty at NYU Medical Center for 7 years before moving to Connecticut in 2005. Currently, Dr. Chang is Associate Professor of Der matology and Pediatrics at the University of Connecticut School of Medicine where she runs a busy clinic and enjoys teaching medical students as well as der matology and pediatric resident physicians She has published extensively in the literature and frequently lectures regionally and nationally Her interests include hemangiomas and vascular malfor mations, severe acne, atopic der matitis, and clinical drug trials

Key Strategic Targets for Mitigating Acne-Affected Skin

Ratan K. Chaudhuri (Sytheon Ltd )

We have come a long way since 1896, when it was suggested that Propionibacterium acnes found in acne lesions was the cause of acne. Recently, high resolution core genome analysis combining 16S rRNA gene sequences led to changing the name of P acnes to Cutibacterium acnes (Scholtz et al , Int J Sys Evo Microbiol , 66: 4422-4432, 2016) While the commensal bacterium C acnes is involved in the maintenance of healthy skin, it can also act as an opportunistic pathogen in acne vulgaris Recent studies have shown that the relative abundance of C acnes (in metagenomics studies) is similar among patients with acne and healthy individuals (87%–89%) or even higher in healthy subjects (89% to 94%) Multiple studies highlighted that the severity of acne might not only be due to a specific C. acnes strain but also due to host and environmental factors. Early and intense inflammatory events in the epider mis have indeed been shown to contribute to the development of acne

Typically, the mean lifetime of each acne lesion is a few days for inflammatory and a few weeks for non-inflammatory ones. Two distinct, partially overlapping, processes need to be addressed during the treatment of acne One is accelerating the healing of the ongoing lesions and the other one is to prevent the huge number of sebaceous glands prone to enter the acne cycle. Therefore, the key strategic targets in acne care appear to be the pilosebaceous follicle that is not yet involved in the acne cycle and the second one is to adequately control the key switching factors of comedone formation for long term relief A multi-tasking strategy is needed to improve the conditions of acne-affected skin. Taking all these factors into consideration, we will address key targets gover ning acne therapy while preventing hyperpigmentation issues. Discussions will also include reasons for selecting ingredients for mitigating acne-affected skin

n Ratan K. Chaudhuri, Ph.D.

Dr. Chaudhuri is President and CEO of Sytheon, which he founded in 2006. Sytheon is an innovative global specialty ingredient company Sytheon’s global headquarters is in Parsippany, New Jersey, USA with its two affiliates in France and Singapore Ratan is a humble entrepreneur by heart and a thinker with strong leadership skills He has developed numerous best-in-class products for the personal care industry, just to name two recent gold standards – Sytenol A (Bakuchiol) and Synovea HR (Hexylresorcinol) Ratan holds over 100 U S and inter national patents and has over 100 publications including six book chapters Ratan has been named as one of the top 10 inspiring business leaders by Inc. Magazine to watch in 2022. He can be reached by telephone (+1 201-303-5594) or e-mail (ratan@sytheonltd com)

Challenges Commonly Encountered with Acne Therapy

Hilary Baldwin (Acne Treatment and Research Center)

In this presentation, we will address challenges in topical and oral acne treatment. Topical retinoids are the mainstay of acne therapy They improve existing lesions, and prevent the development of the microcomedones, which are the predecessors of future lesions However, topical retinoids can be irritating, especially in the first few weeks of treatment. This often leads to inconsistent use or discontinuation Benzoyl peroxide is a highly effective, rapid-onset antibacterial which does not promote the development of bacterial resistance. It also decreases the development of antibacterial resistance to both topical and oral antibiotics with which is it used in combination Unfortunately, benzoyl peroxide is a concentration-dependent irritant it bleaches fabric and is an uncommon sensitizer

Oral antibiotics are highly effective in treating the inflammatory lesions of acne. However, the effects are rarely durable resulting in overuse and the development of bacterial resistance Pregnant and lactating women often experience acne. Unfortunately, clinical trials do not include this population and as such, little exists in the way of efficacy or safety data As a result, these patients are generally told by their obstetricians to forgo treatment until delivery/weaning regardless of the severity of their disease.

Isotretinoin can be used to treat the most severe cases of acne and 80% of those who complete a course will not need acne treatment again It should be noted that there are many potential side effects of the drug, most of which are easily managed. The inter net tells a different story, however, frightening patients with misinfor mation n Hilary Baldwin, M.D.

Hilary Baldwin is a board-certified der matologist and Medical Director of the Acne Treatment and Research Center in Brooklyn, New York She is a Clinical Associate Professor of Der matology at Rutgers Robert Wood Johnson Medical Center Dr Baldwin has interests in acne, rosacea, keloidal scarring, cosmeceuticals, and the skin microbiome She is a frequent national and international lecturer and visiting professor, and her work has been published extensively in der matology jour nals Dr Baldwin served as a founding board member and second president of the American Acne and Rosacea Society.

Multi-modal and 3D Imaging for Objective Evaluation of Acne

Sachin V. Patwardhan (Canfield Scientific Inc )

Lesion counts and Investigators Global Assessment (IGA) are the primary endpoints in acne clinical studies. However, they both suffer from inter- and intra-evaluator variability. Characteristics of acne lesions can be captured, detected, and objectively measured using multi-modal imaging

Collectively these detected characteristics can identify both inflammatory and non-inflammatory lesions, and the measurements can be translated to a global severity score These objective measurements have been used in several clinical studies as exploratory endpoints or for verifying subject enrollment Canfield Scientific’s VISIA-CRP now combines multi-modal imaging with micron-resolution 3D facial imaging. This has further improved the ability to detect, and measure, raised topography of acne lesions VISIA-CRP and its early use in reducing variability in clinical trials, standardizing outcomes, and obtaining more insights into treatment effects will be presented

(continued on Page 40)

n Sachin V. Patwardhan, Ph.D.

Dr Sachin V Patwardhan is the Chief Intellectual Property Officer and Senior Principal Scientist at Canfield Scientific Inc. He developed a multi-spectral imaging device for early diagnosis of melanoma during his Ph D at New Jersey Institute of Technology (NJIT). He then helped in establishing the optical radiology lab at Washington University School of Medicine in Saint Louis while doing postdoctoral research His research there involved developing a small animal diffuse optical and fluorescence tomography system for studying disease models with targeted treatment Since then, for the past 16 years he has focused his research on developing optical imaging techniques and image analysis algorithms for objective assessment of skin diseases and aesthetic conditions at Canfield Scientific Inc His work is published in several jour nals, and he has 11 granted patents and counting

Category Insights and Consumer Trends

Francine Krenicki (Crown Laboratories) n Francine Krenicki

In this presentation we will discuss the acne category's past, present, and future. We will analyze and provide insight to where acne treatment is headed in the future and share some experiences of what works for selected brands. In addition, we will dive into ingredient trends and consumer insights.

Francine Krenicki is a beauty executive with over 20 years of experience specializing in new product development, innovation, and brand strategy and has created award winning for mulas in product categories including skincare, color, personal care, haircare, and fragrance She has dedicated her career to creating meaningful product innovation that resonates with consumers and creates consistent brand loyalty Currently Francine is the Senior Vice President of Global Product Development for Crown Laboratories where she oversees innovation for eight skincare brands including the iconic PanOxyl Acne line as well as the top selling premium clinical skincare brand StriVectin Prior to joining Crown Laboratories, Francine launched the clean clinical skincare brand Skinfix.

Cutibacterium Acnes, Phages, and Acne

Nathan Brown (Parallel Health)

Acne vulgaris was first attributed to Cutibacterium acnes bacteria isolated from acne lesions by Raymond Sabouraud in 1897 Bacteriophages (phages), which infect bacteria, have been used to treat bacterial infections since they were discovered in the early 20th century Phages have been used to treat acne almost as long In some cases, Staphylococcus phages were used, and in other cases, Cutibacterium phages were used, which reflects the long-standing debate over which bacterium “exactly” is involved in the development of acne Currently, specific phylotypes of C acnes are thought to be involved in acne, though it’s still debated whether C. acnes has any role to play. Unfortunately, Koch’s Postulates cannot be used to clarify the role of C acnes in acne vulgaris because the bacteria are ubiquitous on healthy skin with sebaceous glands New methods such as fine-scale population genomics of C. acnes isolated from hair follicles, shotgun metagenomics methods, and topically applied phages may shed light on the role of C acnes and other bacteria in the development of acne.

n Nathan Brown, Ph.D.

Dr Nathan Brown ear ned his Ph D in microbiology in 2016 from Oregon State University, where he worked on bacteriophage and bacterial genomics, and used metagenomics to study bacterial ecology. He did postdoctoral work on phage therapy at the University of Leicester in Leicester, UK He left academia in

2018 to develop the world’s first phage-based cosmetic product, launched in March 2020. Since 2020, he and his cofounder, Natalise Kalea Robinson, have been developing personalized phage-based cosmetics paired with an advanced skin microbiome test at Parallel Health He has over 15 years of experience working with bacteriophages in different capacities and is passionate about introducing phages to the general population as part of a better way of life

Evaluation of Microbiome Changes Related to Cleanser Use in Healthy and Acne Prone Skin

Amina Bouslimani (L’Oréal USA)

Topical acne management involves a judicially chosen treatment regimen paired with a compatible cleanser to remove dirt and excess oil without compromising protective lipid and microbiome barrier, while addressing acne-related microbiome imbalance. To build knowledge on the acute and long-ter m effect of cleansers on skin properties and the microbiome in healthy and acne-prone skin, different types of cleansers were evaluated over a 28-day regimen. Facial microbiome samples were collected at different intervals after cleansing and analyzed by 16S rRNA sequencing and qPCR The effect of cleansing on sebum and skin hydration was evaluated at the same time points

All cleansers had a similar and transient effect on sebum, hydration, and bacterial diversity immediately after cleansing Cleanser composition had however a differential effect on the kinetics of skin properties and microbiome recovery. These results implicate the importance of future studies to support development of next generation cleansers for healthy and acne prone skin n Amina

Bouslimani, Ph.D.

Currently a Senior Scientist at L’Oréal Research and Innovation, Amina establishes exter nal partnerships with academia and industry to accelerate knowledge about the skin microbiome and identify new technologies and actives for compromised skin Amina completed her Ph D in biochemistry and biomedical sciences at the University of Montpellier in France where she studied the penetration and intra-tumoral metabolism of chemotherapeutic drugs in clinical samples using imaging mass spectrometry techniques She completed a postdoctoral fellowship and then worked as a Project Scientist at the University of California San Diego in Professor Pieter Dorrestein’s laboratory She developed metabolomics-based tools to analyze and visualize large-scale metabolomics data and to link skin metabolites to their associated microbes Her research interests are studying the impact of individual lifestyles on skin metabolites and microbes, identifying molecular biomarkers of skin conditions, and forensic applications to link skin chemical signatures to molecular traces transferred to everyday objects.

Novel Solutions for Acne Derived from the Manuka Plant

Merve Samur (Manuka Bioscience)

Acne is a common skin condition that affects millions of people worldwide. Traditional treatments for acne include antibiotics and topical agents such as benzoyl peroxide and salicylic acid However, these treatments are often associated with side effects and may not be effective for all individuals. Recent research has demonstrated the potential of natural products in the treatment of acne. In particular, East Cape mānuka oil and Australian tea tree oil have been found to possess potent antimicrobial and anti-inflammatory properties that can be har nessed for acne treatment.

East Cape mānuka oil contains up to 33% β-triketones, which have been found to be highly effective against gram-positive bacteria such as Cutibacterium acnes and Staphylococcus epider midis, with MIC values of 0.07% and 0.05-0.078%, respectively. Australian tea tree oil, on the other hand, is highly effective against gram-negative bacteria and has been found to have greater efficacy against fungi such as Candida albicans. The combination of these two oils has been shown to offer enhanced antimicrobial activity,

(continued on Page 42) making it suitable for various therapeutic, skincare, and consumer applications

We created a synergistic blend of East Cape mānuka oil concentrate and palmarosa oil that has been found to have a range of skincare benefits, including anti-inflammatory, antibacterial, and anti-acne properties. In particular, the mānuka-palmarosa oil blend has been found to be highly effective in reducing the UVR-induced IL-1b inflammatory response in skin fibroblast cells Its antibacterial properties have also been evaluated against various pathogens, including MRSA and Vancomycin-resistant Enterococcus species, providing a valuable alter native solution in combating antimicrobial resistance.

In anti-acne applications, a gel containing 2% (w/w) of the mānuka-palmarosa oil blend, PEG-6, and PEG-30 was found to be considerably more effective than traditional acne treatments such as 2.5% (w/w) benzoyl peroxide and 2% (w/w) salicylic acid Specifically, the mānuka-palmarosa oil blend gel was 76% more effective against C acnes and 35% more effective against S epider midis when compared to 2 5% (w/w) benzoyl peroxide When compared to 2% (w/w) salicylic acid, the gel was 141% more effective against C acnes and 244% more effective against S epider midis

In conclusion, East Cape mānuka oil offers a promising natural alter native for acne treatment. A synergistic blend of manuka and palmarosa oil has demonstrated potent anti-inflammatory, antibacterial, and anti-acne properties, making it a versatile and effective skincare product for individuals seeking healthier, clearer skin n Merve Samur

Merve Samur is an accomplished chemical for mulation designer with extensive experience in both FMCG and contract manufacturing. Based in Auckland, New Zealand, Merve has led the development of a wide range of skincare, hair care, and natural home care products for over 10 years. Merve is currently the R&D Manager of Manuka Bioscience where she oversees the complete product development lifecycle from concept through production Prior to this, she held positions as the Research & Development Manager and Product Development Specialist at The Cosmetic Company, also in Auckland Merve holds a bachelor’s degree in chemistry from the Izmir Institute of Technology. She has recently been awarded for her for mulations: Pure Beauty Awards 2022 – Best Serum; Health Post Best of Natural Awards 2022 – ManukaRx Eye Cream.

Acne Vulgaris in the United States: Burden of Disease and Prescribing Trends

Ayman Grada (Case Wester n Reserve University School of Medicine)

Acne vulgaris is the most common reason for pediatric patients and third most common reason for adult patients to seek care from a der matologist in the U S If not treated effectively, acne can lead to per manent scars. Acne is also associated with a significant psychosocial burden that impacts quality of life However, referring providers may be reluctant to initiate patients on acne treatment or certain prescriptions. In this presentation, we will review current temporal trends in epidemiology and burden of disease in the U S stratified by age, gender, and region We will share some insights on the evolving treatment paradigm and prescribing habits among der matologists and other clinicians treating acne vulgaris.

n Ayman Grada, M.D.

Dr. Grada is a U.S.-trained der matologist and a physician-scientist with over 17 years combined clinical practice, academic research, and regulated biopharma and biotech experience. He currently serves as an Adjunct Professor of Der matology at Case Wester n Reserve University School of Medicine Dr Grada finished his der matology training and a postdoctoral fellowship in cutaneous wound healing at Boston University School of Medicine. He has published more than 120 articles in peer-reviewed jour nals on medical der matology, including acne vulgaris, actinic keratosis, wound healing, and epidemiology topics. Dr. Grada