Atrophic acne scars and post-acne hyperpigmentation: potential and prospects of trifarotene cream

The problem of effective prevention and treatment of the post-acne sequelae has substantial medical and social relevance due to its high prevalence, the tendency to form disfiguring cosmetic defects on exposed skin areas, a marked reduction in quality of life, and the development of psychosomatic disorders and substantial social maladaptation in patients. Pronounced post-inflammatory pathological scarring develops at early stages of the dermatosis and is observed in the majority of patients with severe acne; patients typically seek medical care for these changes approximately one year after onset. Data from global studies indicate that topical retinoids not only control the formation of new scar structures, but also improve pre-existing skin defects. A new highly selective fourth-generation retinoid, trifarotene, has been introduced into international dermatologic practice. The trifarotene molecule demonstrates high selectivity for retinoic acid receptor gamma (RAR-γ). Its mechanism of action, efficacy, and safety profile have been evaluated in numerous preclinical and clinical studies. Trifarotene has been shown to be well tolerated, with mild erythema and skin dryness. Molecular studies of trifarotene suggest promising clinical applications for preventing postinflammatory hyperpigmentation and reducing the severity of scarring during treatment of acne vulgaris of varying severity. This article presents the authors’ clinical experience with trifarotene in patients of different age groups and skin phototypes presenting with post-acne sequelae. The clinical cases demonstrate marked therapeutic efficacy, including in patients with a long disease history and mature scars, which are traditionally considered unfavorable prognostic factors. These findings suggest that trifarotene may be considered not only as a preventive agent against scar formation but also as a component of therapy for established atrophic changes, particularly with long-term use.