Acne, Rosacea Trends in 2025, with Shanna Miranti, PA-C

During her talk at the 2025 New Wave Dermatology Meeting in Aventura, Florida, Miranda Miranti, MPAS, PA-C, a physician assistant at Riverchase Dermatology, discussed 2025 trends in acne and rosacea. She also talked about overlapping treatments for the 2 skin conditions.

HCPLive sat down with Miranti at the meeting to discuss these trends and overlapping therapies, along with her other presentation on when to move from topical to systemic treatment for acne.

Acne Trends

The first acne trend Miranti talked about was keeping it simple. Treat as many of the 4 pillars of acne pathogenesis—increased sebum production, follicular hyperkeratinization, cutibacterium acnes, and inflammation—with the least number of steps.

“What's truly important when treating acne in 2025 is to keep things simple,” Miranti said. “We don't want to create very complex regimens for our patients because, typically, the more medicines that we prescribe for patients, the less they're going to do and the less they will be compliant with.”

Miranti recommends starting with a once-daily monotherapy. Another treatment trend is 1726-nanometer acne lasers, such as AVICLEAR, the first 1726 nm on the market that clears acne by targeting the sebaceous glands and reducing inflammation. The FDA had cleared AVICLEAR in March 2022. The second laser to be FDA cleared was ACCURE, targeting sebum in the sebaceous gland.

Other trends include addressing post-inflammatory hyperpigmentation and scarring early by using topicals, having completely clear skin, and the spread of bad skincare advice on TikTok.

Rosacea Trends

Until recently, it has been slow in the rosacea space. Miranti mentioned a new drug on the market—an oral low-dose 40 mg minocycline HCI Extended-Release Caps that can reduce redness, papules, and pustules.

Rosacea treatment trends are becoming more sophisticated. Rather than just prescribing RX Metronidazole, a patient may need all the following: An oral low-dose, sub-antimicrobial, anti-inflammatory dose of antibiotic, a vasoconstrictor in the morning to control persistent facial erythema, and a topical like Ivermectin to address the papules and pustules. On top of that, your patient may need pulse dye laser treatments to destroy Telangiectasia and a good skincare routine for those with rosacea.

Treating Both Acne and Rosacea

Miranti stressed the importance of being very specific with skincare recommendations when a patient has both acne and rosacea. A patient will need a therapeutic regimen that can help their skin without compromising their skin barrier and aggravating either acne or rosacea.

“One interesting overlap is benzoyl peroxide,” Miranti said. “For years, I did not believe benzo peroxide should ever be used on a rosacea patient until a [benzoyl peroxide] therapy came out and was specifically FDA approved for rosacea a number of years ago. This therapy proves that certain formulations of benzoyl peroxide can be used on our rosacea patients and can and can get some very nice efficacy.”

Relevant disclosures for Miranti include Galderma Laboratories,Incyte Corporation, Verrica Pharmaceuticals, Ortho Dermatologics, a division of Bausch Health US, Almirall, and Arcutis Biotherapeutics.