Clascoterone
Clascoterone
The topical anti-androgen — the same target as oral spironolactone, acting where the acne is. Irritation no worse than its own vehicle.
The marker is the strength the trials were actually run at. The bar is the span this register has recorded, approved and compounded together. Anything below the marker is a dose nobody has tested; anything above it is an assumption about a dose–response curve nobody has drawn.
The shaded band is the depth this molecule is understood to reach. Anything below it is out of scope, whatever the label says.
Mechanism
Competes with dihydrotestosterone at the androgen receptor in the sebaceous gland and hair follicle. The label states that the mechanism of action for acne itself is unknown.
HOUSE NOTES
- Across eight measured local reaction types, none was meaningfully worse than vehicle — erythema and skin atrophy were both lower on drug than on the cream base.
- Topical does not mean local. HPA axis suppression appeared in 5% of adults and 9% of adolescents after fourteen days, reversing within four weeks of stopping.
- Trialled at a mean age of 19.7 and marketed for adult hormonal acne. The receptor is the same receptor; the evidence for that use is extrapolation.
- A 60 g tube must be discarded one month after opening, which for most users means binning a substantial share of an expensive tube on the label's own instruction.
MEASURED ENDPOINTS
SUPPORTING RECORDS
Multicentre randomised, vehicle-controlled; treatment difference 14.3% (95% CI 8.9–19.7)
N=729 · 12 WK · DOUBLE-BLIND
Open-label pharmacokinetic study, twice-daily application, adults and adolescents
N=42 · 2 WK · OPEN-LABEL
Layering
- Cuts, abrasions, eczematous or sunburned skin
- Retinoids
- Benzoyl peroxide