Nitric Oxide Treats Acne from the ‘Bottom Up’


Nitric oxide is the key ingredient in a new acne treatment that is meant to remodel the skin from the “bottom up.” Novan Inc. looked at the physiology of acne when creating the candidate product (SB204) in an attempt to stop the underlying inflammation contributing toward the condition.

The topical nitric oxide-releasing gel is thought to be a gentler way to treat microcomedones compared to retinoids, which focus on the same component of acne pathology by working from the skin surface down. The oxide itself is thought to inhibit production of the pore-clogging cytokines in acne, such as IL-1β, along with potentially putting a stop the NLRP3 inflammasome assembly.

SB204 has a 4% concentration meant to be taken once daily. It is prescription only, and is expected to be commercially available in 2019.


Three studies were performed in order to determine the safety of the gel, which addressed if nitric oxide remains in the skin and cardiovascular safety.

The first and second studies found that the gel left no detectable systemic nitric oxide exposure after application for five and 21 days, respectfully. Nitrate was used as a marker for the nitric oxide, with the active gel in the first study containing a similar level of nitrate as the placebo.

The third study tested 48 adults with acne with doses of the 4% concentration against a higher 12% concentration, including a placebo and positive control. Researchers found that the groups did not experience differences in cardiovascular parameters or in systemic nitrate levels.

Read more about nitric oxide at Dermatology Times (source).

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