When do you prescribe clascoterone cream for your acne patients?

Clascoterone cream can be beneficial in anyone who has acne. I do believe it should be used BID and I generally couple it with a topical retinoid. Remember that we are always trying to hit all four of the pathogenic targets in acne. Those targets are follicular hyperkeratinization, inflammation, C acnes and sebum. We don't have much that reduces sebum aside from isotretinoin or oral contraceptives and spironolactone in women. Therefore, anytime you are NOT using one of those, there is a potential opportunity for clascoterone. Clascoterone does not appear to have an impact on follicular hyperkeratinization or C acnes and will be best used in combination with other products that do (i.e. a topical retinoid and BPO for example).