Clerkson cream (Winlevi) is the first local androgen receptor inhibitor, suitable for the treatment of acne vulgaris in patients aged 12 and above, by blocking the androgen signaling pathway of hair follicle sebaceous gland units. Attention should be paid to skin irritation reactions, medication contraindications for special populations, and drug interaction risks when using.

1 Indications

(1) Target audience: Patients with mild to moderate acne vulgaris aged 12 years and above, especially those who have not responded to traditional tretinoin/antibiotic treatment.

(2) Mechanism of action: Selective inhibition of local androgen receptors, reduction of sebum secretion and inflammatory response, without causing systemic hormonal imbalance.

(3) Therapeutic characteristics: Clinical studies have shown that after 12 weeks of medication, the reduction rate of inflammatory skin lesions is 48-52%, and the reduction rate of non inflammatory skin lesions is 35-40%.

2 Medication precautions

(1) Usage: Apply thinly to the affected area twice a day, avoiding the eye area/mucous membrane. Wash hands after medication.

(2) Common reactions: About 23% of patients experience dryness/flaking at the medication site, and it is recommended to use oil-free moisturizers to alleviate the symptoms.

(3) Special populations: Prohibited during pregnancy (animals show fetal toxicity), avoid chest use during lactation, safety has not been established for children under 12 years old.

3 drug interactions

(1) Prohibition of combination use: Other local androgen inhibitors may enhance skin irritation response.

(2) Caution in combination: Strong CYP3A4 inhibitors (such as ketoconazole cream) may increase systemic exposure.

(3) Monitoring requirements: Liver function should be checked every 3 months when combined with systemic anti androgen drugs.

4. Handling of Adverse Reactions

(1) Mild irritation: can be reduced to once daily use, combined with cold compress for relief.

(2) Contact dermatitis: Immediately discontinue use and apply weak acting corticosteroids (such as hydrocortisone 1%) topically.

(3) Severe allergy: If vascular edema occurs, emergency treatment with adrenaline is required.