Andrew Alexis, MD, MPH: Future of Managing Acne Hyperpigmentation with Trifarotene


During this interview segment, Alexis was asked how trifarotene, in combination with an appropriate skincare routine, addresses post-inflammatory hyperpigmentation in skin of color.

Patients who implemented trifarotene reported improvements in their post-acne vulgaris hyperpigmentation index (PAHPI) scores and overall disease severity (ODS), according to recent data. The investigators, led by Andrew F. Alexis, MD, MPH, noted that a plan in which trifarotene was combined with other skincare methods resulted in increased satisfaction and adherence among patients.1

Alexis serves as a professor of clinical dermatology at Weill Cornell Medicine. In this interview segment, Alexis was asked by the HCPLive editorial team about these findings and their implications for patients with skin of color, given the study’s focus on this population.

“When we looked at specific endpoints, starting with the ODS score, there was a significantly greater reduction in that overall disease severity score at Week 12,” Alexis explained. “However, at Week 24 - the primary endpoint - it was actually comparable between the trifarotene and the vehicle groups. On the other hand, when we looked at the secondary endpoint of PAHPI score, that composite of lesion size, intensity number, there were significantly greater reductions in the trifarotene group at Week 24, as well as Week 20.”

Alexis explained that, taken together, these findings suggested there was evidence for more rapid improvement in post-inflammatory hyperpigmentation as well as more robust improvement as measured by the PAHPI at Week 24. He was also asked about the drug’s safety profile.

“When it comes to safety, we were able to demonstrate that treatment with trifarotene was associated with an overall mild degree of adverse events related to tolerability,” Alexis said. “So overall, it was very well tolerated in our patients of all skin types.”

Later, Alexis was asked, based on the study's outcomes, what implications or recommendations he foresees for dermatologists in managing acne sequelae.

“I think some of the key takeaways from the study are that it lends further support to the strategy of using topical retinoids,” Alexis explained. “In this case trifarotene, for the management of both acne and acne-induced hyperpigmentation and by being able to achieve more rapid improvement in hyperpigmentation and more robust improvement in hyperpigmentation.”

To find out more, view Alexis’s full interview segment posted above the summary.

The quotes used in this summary were edited for the purposes of clarity. Alexis has served as a consultant and/or advisory board member for Sanofi Regeneron, Novartis,UCB, Dermavant, Galderma Laboratories LP, Beiersdorf, Leo, Unilever, L'Oreal, Scientis, Valeant, Bausch Health, Allergan, Arcutis, Janssen, Bristol Meyers Squibb, Almirall, AbbVie, and Sol-Gel.


  1. Alexis A, Del Rosso J, Stein-Gold L, et al. (2024). Importance of treating acne sequelae in skin of color: 6-month phase IV study of trifarotene with an appropriate skincare routine including UV protection in acne-induced post-inflammatory hyperpigmentation. Int J Dermatol.
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