John Barbieri, MD, MBA
@drjohnbarbieri.bsky.social
Derm @bwhdermatology (acne, epi, patient-reported outcomes, antibiotic stewardship, high-value care). Assoc Ed @JAMADerm. Views are mine, not medical advice.
Please join us for Acne Global Education day on June 7th. We have an all-star cast lined up and it is going to be an outstanding session on everything acne. For more and to register:
www.global-dermatology.com/en/events/ac...
www.global-dermatology.com/en/events/ac...
ACNE | Global Education Day 2025
ACNE Global Education Day 2025: join top experts online for clinical insights, treatment updates, and expert discussions at global-dermatology.com.
www.global-dermatology.com
June 5, 2025 at 5:41 PM
Please join us for Acne Global Education day on June 7th. We have an all-star cast lined up and it is going to be an outstanding session on everything acne. For more and to register:
www.global-dermatology.com/en/events/ac...
www.global-dermatology.com/en/events/ac...
Some more evidence from a meta-analysis of 6 RCTs to support that subdermal implants (i.e. Nexplanon) are more likely to cause acne than hormonal IUDs (OR 2.21). Something to keep in mind for those concerned about acne who otherwise don't have strong preferences.
pubmed.ncbi.nlm.nih.gov/40069520/
pubmed.ncbi.nlm.nih.gov/40069520/
Subdermal implants vs. levonorgestrel intrauterine devices outcomes in reproductive-aged women: a systematic review and meta-analysis - PubMed
PROSPERO ID: CRD42024516472.
pubmed.ncbi.nlm.nih.gov
March 13, 2025 at 1:49 PM
Some more evidence from a meta-analysis of 6 RCTs to support that subdermal implants (i.e. Nexplanon) are more likely to cause acne than hormonal IUDs (OR 2.21). Something to keep in mind for those concerned about acne who otherwise don't have strong preferences.
pubmed.ncbi.nlm.nih.gov/40069520/
pubmed.ncbi.nlm.nih.gov/40069520/
🚨 News Alert 🚨
The FDA just released an important update regarding benzene in benzoyl peroxide products (www.fda.gov/drugs/drug-s...). See below for my thoughts and products to avoid:
The FDA just released an important update regarding benzene in benzoyl peroxide products (www.fda.gov/drugs/drug-s...). See below for my thoughts and products to avoid:
Recalls small number of acne products for benzene contamination
Voluntary recalls of acne products after FDA testing finds small number of proudcts with elevated levels of benzene
www.fda.gov
March 12, 2025 at 6:59 PM
🚨 News Alert 🚨
The FDA just released an important update regarding benzene in benzoyl peroxide products (www.fda.gov/drugs/drug-s...). See below for my thoughts and products to avoid:
The FDA just released an important update regarding benzene in benzoyl peroxide products (www.fda.gov/drugs/drug-s...). See below for my thoughts and products to avoid:
A new report on the potential relationship between benzene and benzoyl peroxide was just released in @theJIDJournal. While I applaud continued efforts to address this important topic, I have some serious concerns with this study. 1/8
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
A Disproportionality Analysis on Benzoyl Peroxide and its Risk of Malignancy using the FDA Adverse Event Reporting System
www.sciencedirect.com
March 7, 2025 at 2:30 PM
A new report on the potential relationship between benzene and benzoyl peroxide was just released in @theJIDJournal. While I applaud continued efforts to address this important topic, I have some serious concerns with this study. 1/8
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
There is growing interest in the role of home LED therapy for acne. In this systematic review and meta-analysis in JAMA Derm, we examine the evidence base for this treatment (TL/DR: it appears to have reasonable efficacy for mild acne):
www.massgeneralbrigham.org/en/about/new...
www.massgeneralbrigham.org/en/about/new...
Researchers Find At-Home LED Devices for Acne Treatment Are Safe and Effective for Skincare Routines | Mass General Brigham
In a review and meta-analysis of previous studies, researchers from Mass General Brigham found red and/or blue light devices were effective in treating mild-to -moderate acne.
www.massgeneralbrigham.org
March 5, 2025 at 5:59 PM
There is growing interest in the role of home LED therapy for acne. In this systematic review and meta-analysis in JAMA Derm, we examine the evidence base for this treatment (TL/DR: it appears to have reasonable efficacy for mild acne):
www.massgeneralbrigham.org/en/about/new...
www.massgeneralbrigham.org/en/about/new...
While we often worry about SJS/TEN with TMP-SMX, it also can be associated with severe acute respiratory failure, particularly among younger individuals. Another reason to be very cautious about using it for acne:
pubmed.ncbi.nlm.nih.gov/40012193/
pubmed.ncbi.nlm.nih.gov/40012193/
Severe Acute Respiratory Failure Associated With Trimethoprim/Sulfamethoxazole Among Adolescent and Young Adults: An Active Comparator-Restricted Disproportionality Analysis From the FDA Adverse Event...
TMP-SMX may increase the risk of ARF/ARDS, requiring further validation in larger pharmacoepidemiological studies. Our findings lay the groundwork for future research to further investigate the safety...
pubmed.ncbi.nlm.nih.gov
February 27, 2025 at 2:07 PM
While we often worry about SJS/TEN with TMP-SMX, it also can be associated with severe acute respiratory failure, particularly among younger individuals. Another reason to be very cautious about using it for acne:
pubmed.ncbi.nlm.nih.gov/40012193/
pubmed.ncbi.nlm.nih.gov/40012193/
Sherry Ershadi, an amazing research fellow in our lab this year, has put together these incredible acne/rosacea patient handouts. Feel free to use them if you find them helpful:
barbierilab.bwh.harvard.edu/educational-...
barbierilab.bwh.harvard.edu/educational-...
Educational Handouts – Barbieri Lab
barbierilab.bwh.harvard.edu
February 26, 2025 at 7:05 PM
Sherry Ershadi, an amazing research fellow in our lab this year, has put together these incredible acne/rosacea patient handouts. Feel free to use them if you find them helpful:
barbierilab.bwh.harvard.edu/educational-...
barbierilab.bwh.harvard.edu/educational-...
Lately, we've seen a lot of discussion about the potential risk of benzoyl peroxide products breaking down into benzene. In this letter, we discuss some of the limitations with respect to the methodology and framing of the recent Kucera et al. article in the JID:
www.jidonline.org/article/S002...
www.jidonline.org/article/S002...
The need for transparency and careful messaging regarding the potential for benzoyl peroxide products to form benzene
We read with interest the article by Kucera et al. (Kucera et al. 2024) and agree
that this topic is of tremendous importance given the ubiquitous use of benzoyl peroxide
(BPO) for acne and other skin...
www.jidonline.org
February 26, 2025 at 6:39 PM
Lately, we've seen a lot of discussion about the potential risk of benzoyl peroxide products breaking down into benzene. In this letter, we discuss some of the limitations with respect to the methodology and framing of the recent Kucera et al. article in the JID:
www.jidonline.org/article/S002...
www.jidonline.org/article/S002...
Minocycline-MR 40mg was recently FDA approved for rosacea. In this video, I will review the clinical trial data and share my thoughts on where it fits among our existing treatment options:
#rosacea #minocycline #emrosi
youtu.be/103ncqVznGk
#rosacea #minocycline #emrosi
youtu.be/103ncqVznGk
How good is the new Minocycline-MR (Emrosi) for rosacea | Dermatologist explains
YouTube video by John Barbieri, MD
youtu.be
February 19, 2025 at 2:21 AM
Minocycline-MR 40mg was recently FDA approved for rosacea. In this video, I will review the clinical trial data and share my thoughts on where it fits among our existing treatment options:
#rosacea #minocycline #emrosi
youtu.be/103ncqVznGk
#rosacea #minocycline #emrosi
youtu.be/103ncqVznGk
Just out in BJD, interesting MR study lending further support to the potential role of Omega-3 being helpful in acne. These findings align with small trials and observational studies suggesting Omega-3 may be useful. 1/2
pubmed.ncbi.nlm.nih.gov/39936505/
pubmed.ncbi.nlm.nih.gov/39936505/
The causal association between polyunsaturated fatty acids and acne: A two-sample Mendelian randomization study - PubMed
Our study indicates that high DHA levels and their ratios to total fatty acids have causal protective effects against acne, while high LA levels and omega-6: omega-3 ratio are associated with increase...
pubmed.ncbi.nlm.nih.gov
February 13, 2025 at 2:29 PM
Just out in BJD, interesting MR study lending further support to the potential role of Omega-3 being helpful in acne. These findings align with small trials and observational studies suggesting Omega-3 may be useful. 1/2
pubmed.ncbi.nlm.nih.gov/39936505/
pubmed.ncbi.nlm.nih.gov/39936505/
Excited to share work with @labmuffin.com, Courtney Rubin, and James Pham, identifying how formulation characteristics might be associated with benzene levels in benzoyl peroxide products. Some helpful hypotheses to guide future product development.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
The Role of Formulation in Benzene Formation in Benzoyl Peroxide Products
This quality improvement study examines the effects of formulation on benzene levels detected in over-the-counter benzoyl peroxide products.
jamanetwork.com
February 12, 2025 at 4:32 PM
Excited to share work with @labmuffin.com, Courtney Rubin, and James Pham, identifying how formulation characteristics might be associated with benzene levels in benzoyl peroxide products. Some helpful hypotheses to guide future product development.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
In this latest video, I review common reasons why isotretinoin is not working and how to address these clinical scenarios:
youtu.be/gEc2qxdEH6Q
youtu.be/gEc2qxdEH6Q
Why Accutane (isotretinoin) isn’t working | Dermatologist and acne expert explains
YouTube video by John Barbieri, MD
youtu.be
February 6, 2025 at 8:11 PM
In this latest video, I review common reasons why isotretinoin is not working and how to address these clinical scenarios:
youtu.be/gEc2qxdEH6Q
youtu.be/gEc2qxdEH6Q
We often consider GoodRx to reduce out-of-pocket costs. In this @JAADjournals study, we find that @costplusdrugs frequently has lower prices for derm drugs (and the mail order aspect may be more convenient). Another good option to help with affordability.
pubmed.ncbi.nlm.nih.gov/39863169/
pubmed.ncbi.nlm.nih.gov/39863169/
Comparing Prescription Drug Saving Platforms for Dermatology: A Cost Analysis of Mark Cuban Cost Plus Drugs, GoodRx, and Amazon RxPass - PubMed
Comparing Prescription Drug Saving Platforms for Dermatology: A Cost Analysis of Mark Cuban Cost Plus Drugs, GoodRx, and Amazon RxPass
pubmed.ncbi.nlm.nih.gov
January 27, 2025 at 8:25 PM
We often consider GoodRx to reduce out-of-pocket costs. In this @JAADjournals study, we find that @costplusdrugs frequently has lower prices for derm drugs (and the mail order aspect may be more convenient). Another good option to help with affordability.
pubmed.ncbi.nlm.nih.gov/39863169/
pubmed.ncbi.nlm.nih.gov/39863169/
Just out in @JAMADerm, we describe the psychometric properties of the 1-item ACORN Patient Global Assessment, which correlates well with the CASS IGA and also is highly responsive to change. This can be particularly useful for online surveys/assessments.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Validation of the ACORN Patient Global Assessment
This survey study evaluates the measurement properties for acne severity of the Acne Core Outcome Research Network (ACORN) patient global assessment.
jamanetwork.com
January 22, 2025 at 7:41 PM
Just out in @JAMADerm, we describe the psychometric properties of the 1-item ACORN Patient Global Assessment, which correlates well with the CASS IGA and also is highly responsive to change. This can be particularly useful for online surveys/assessments.
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Should we start with spironolactone or doxycycline for women with acne? Check out my breakdown of the FASCE trial here:
youtu.be/zRbPfSCn9Ow
youtu.be/zRbPfSCn9Ow
Spironolactone or oral antibiotics? Which is best? | FASCE Trial | Dermatologist explains
YouTube video by John Barbieri, MD
youtu.be
January 22, 2025 at 2:08 AM
Should we start with spironolactone or doxycycline for women with acne? Check out my breakdown of the FASCE trial here:
youtu.be/zRbPfSCn9Ow
youtu.be/zRbPfSCn9Ow
Just out in JAMA Dermatology, led by Jenny Lai, we evaluate long-term clearance outcomes among those treated with isotretinoin for acne. A thread: ⬇️
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Acne Relapse and Isotretinoin Retrial in Patients With Acne
This cohort study assess rates of acne relapse and isotretinoin retrial and identifies associated factors in patients after completing an isotretinoin course.
jamanetwork.com
January 15, 2025 at 6:13 PM
Just out in JAMA Dermatology, led by Jenny Lai, we evaluate long-term clearance outcomes among those treated with isotretinoin for acne. A thread: ⬇️
jamanetwork.com/journals/jam...
jamanetwork.com/journals/jam...
Do we really need to check frequent labs for isotretinoin? In this video, I go through the evidence about why we likely aren't getting much value from our current approach and even make a case for no monitoring:
youtu.be/UpsW1iN9FRw
youtu.be/UpsW1iN9FRw
Does Accutane (isotretinoin) require lab monitoring? | Dermatologist and acne expert explains
YouTube video by John Barbieri, MD
youtu.be
January 10, 2025 at 1:30 PM
Do we really need to check frequent labs for isotretinoin? In this video, I go through the evidence about why we likely aren't getting much value from our current approach and even make a case for no monitoring:
youtu.be/UpsW1iN9FRw
youtu.be/UpsW1iN9FRw
Reposted by John Barbieri, MD, MBA
Some of the best evidenced-based info on acne treatment right here! @drjohnbarbieri.bsky.social
#DRESSsyndrome
#acnetreatment
#DRESSsyndrome
#acnetreatment
Want to learn more about which are the best oral antibiotics for the treatment of acne, including the relative role of doxycycline, minocycline, sarecycline (Seysara), trimethoprim-sulfamethoxazole (Bactrim), amoxicillin, and azithromycin, among others? Check out this video:
youtu.be/RgMXi92UjnQ
youtu.be/RgMXi92UjnQ
What are the best antibiotics for acne | Dermatologist and acne expert explains
YouTube video by John Barbieri, MD
youtu.be
December 23, 2024 at 5:43 AM
Some of the best evidenced-based info on acne treatment right here! @drjohnbarbieri.bsky.social
#DRESSsyndrome
#acnetreatment
#DRESSsyndrome
#acnetreatment
Want to learn more about which are the best oral antibiotics for the treatment of acne, including the relative role of doxycycline, minocycline, sarecycline (Seysara), trimethoprim-sulfamethoxazole (Bactrim), amoxicillin, and azithromycin, among others? Check out this video:
youtu.be/RgMXi92UjnQ
youtu.be/RgMXi92UjnQ
What are the best antibiotics for acne | Dermatologist and acne expert explains
YouTube video by John Barbieri, MD
youtu.be
December 22, 2024 at 2:34 AM
Want to learn more about which are the best oral antibiotics for the treatment of acne, including the relative role of doxycycline, minocycline, sarecycline (Seysara), trimethoprim-sulfamethoxazole (Bactrim), amoxicillin, and azithromycin, among others? Check out this video:
youtu.be/RgMXi92UjnQ
youtu.be/RgMXi92UjnQ
Catch up on some of the biggest topics, studies, and new medications for acne in my latest year-in-review video:
youtu.be/vxqxzDYGSsg
youtu.be/vxqxzDYGSsg
Catch up on the biggest acne developments of 2024: Year in Review | Dermatologist Explains
YouTube video by John Barbieri, MD
youtu.be
December 19, 2024 at 1:57 AM
Catch up on some of the biggest topics, studies, and new medications for acne in my latest year-in-review video:
youtu.be/vxqxzDYGSsg
youtu.be/vxqxzDYGSsg
In JAAD, we find evidence that acne may be a risk factor for fractures. This aligns with evidence that acne is associated with low vitamin D levels or might be related to pleiotropy or systemic inflammation
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
DEFINE_ME
www.jaad.org
December 9, 2024 at 2:47 PM
In JAAD, we find evidence that acne may be a risk factor for fractures. This aligns with evidence that acne is associated with low vitamin D levels or might be related to pleiotropy or systemic inflammation
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
Nice article in @nytimes.com covering some of the recent benzene concerns (including benzoyl peroxide) as well as our recent work on this topic.
www.nytimes.com/2024/12/05/w...
www.nytimes.com/2024/12/05/w...
Is It Time to Worry About Benzene in Personal Care Products?
The carcinogen has been found in sunscreen, deodorants, acne creams and other personal care products. Here’s what to know.
www.nytimes.com
December 6, 2024 at 9:28 PM
Nice article in @nytimes.com covering some of the recent benzene concerns (including benzoyl peroxide) as well as our recent work on this topic.
www.nytimes.com/2024/12/05/w...
www.nytimes.com/2024/12/05/w...
Isotretinoin can be highly effective for #acne and is the only prescription treatment that can provide a lasting remission. While we often discuss skin dryness, we don’t often consider the eyes. In this thread, let's explore the effects of #isotretinoin on the eye. #dermsky 1/9
December 2, 2024 at 6:25 PM
Isotretinoin can be highly effective for #acne and is the only prescription treatment that can provide a lasting remission. While we often discuss skin dryness, we don’t often consider the eyes. In this thread, let's explore the effects of #isotretinoin on the eye. #dermsky 1/9
Pityrosporum folliculitis ("fungal acne") can be easy to miss and needs different treatments than run of the mill acne. In this video, I go over what to look for and how to treat this condition:
www.youtube.com/watch?v=n0YH...
www.youtube.com/watch?v=n0YH...
December 2, 2024 at 6:17 PM
Pityrosporum folliculitis ("fungal acne") can be easy to miss and needs different treatments than run of the mill acne. In this video, I go over what to look for and how to treat this condition:
www.youtube.com/watch?v=n0YH...
www.youtube.com/watch?v=n0YH...
Reposted by John Barbieri, MD, MBA
Real world data shows no correlation between benzoyl peroxide use and benzene blood levels, or leukaemia/lymphoma/internal malignancies 👇🏻
I cover some of our research on this subject here:
youtu.be/LSylzH_ikU8
youtu.be/LSylzH_ikU8
Will using benzoyl peroxide for acne cause cancer? | Dermatologist explains latest studies
YouTube video by John Barbieri, MD
youtu.be
November 29, 2024 at 9:18 PM
Real world data shows no correlation between benzoyl peroxide use and benzene blood levels, or leukaemia/lymphoma/internal malignancies 👇🏻