Latest / The Science of Skin / Dr David Osborne, Dermatology's Master Formulator

Transcript

Dr David Osborne, Dermatology's Master Formulator · The Science of Skin

• 0:08
  SPEAKER_00: Hello and welcome to Skin Care Confidential, a podcast dedicated to the insider information in the skincare industry.
• 0:18
  SPEAKER_00: It is also meant to support the Science of Skin Care Summit, an annual educational summit being held this year, 2023, September 21st to the 23rd, in beautiful Austin, Texas.
• 0:30
  SPEAKER_00: My name is Dr.
• 0:31
  SPEAKER_00: Ted Lane.
• 0:32
  SPEAKER_00: I am a board-certified dermatologist.
• 0:34
  SPEAKER_00: I'm a co-founder of the Science of Skin Care Summit, and I'm also your co-host today.
• 0:40
  SPEAKER_00: But more importantly, today we have an amazing guest, someone for all you skincare nerds out there, especially for those of you who are in the dermatologic field, you will know Dr.
• 0:52
  SPEAKER_00: David Osborne's name.
• 0:54
  SPEAKER_00: Dr.
• 0:54
  SPEAKER_00: Osborne is a master formulator.
• 0:58
  SPEAKER_00: And we're going to talk about a couple of the medications that he has formulated, which are really unbelievable, including one called Zareve that we have now for psoriasis.
• 1:10
  SPEAKER_00: Dr.
• 1:10
  SPEAKER_00: Osborne was educated at the University of Missouri in Roland, Missouri.
• 1:16
  SPEAKER_00: He's got a PhD from that program as well as an honorary professional degree in chemistry.
• 1:23
  SPEAKER_00: He received his Bachelor of Science in Chemistry from Southwest Missouri State.
• 1:27
  SPEAKER_00: He is currently the chief technical officer for Arcutis since 2017.
• 1:35
  SPEAKER_00: And before that, he has been involved in many other formulating roles with different companies.
• 1:41
  SPEAKER_00: He also has his own consulting form, consulting company, David W.
• 1:45
  SPEAKER_00: Osborne PhD Consulting.
• 1:47
  SPEAKER_00: So for anybody out there who needs some help with your formulations, reach out to Dr.
• 1:52
  SPEAKER_00: Osborne.
• 1:52
  SPEAKER_00: David, thank you so much for being here.
• 1:54
  SPEAKER_03: Thank you, Ted.
• 1:55
  SPEAKER_03: I really appreciate the invite and looking forward to the next half hour or so.
• 2:00
  SPEAKER_00: Great.
• 2:01
  SPEAKER_00: Well, this is definitely a kind of a different path for us in this podcast because now we really are focused on using medical uh topical formulations as both treatments as well as skin care.
• 2:16
  SPEAKER_00: And I think once we get through what David has used to formulate, you'll understand why.
• 2:21
  SPEAKER_00: So David, just give us some background.
• 2:24
  SPEAKER_00: Why did you get into this field?
• 2:25
  SPEAKER_00: What about formulating topical medications was appealing to you?
• 2:30
  SPEAKER_03: Yeah, so it really started when I began my PhD program at the University of Missouri Rolla, and that uh I happened to have a graduate advisor who at that time, in 1982, uh had won a number of awards for cosmetic chemistry.
• 2:52
  SPEAKER_03: Uh he had in the late 70s he discovered what stabilized emulsions, and these were cosmetic emulsions, and uh he was well renowned throughout the world for that.
• 3:07
  SPEAKER_03: So when I signed on, uh my dissertation was how a skin softener interacts with the lipids in the stratum corneum.
• 3:16
  SPEAKER_00: Got it.
• 3:17
  SPEAKER_00: And from I mean, I guess the rest is history, because honestly, without Dr.
• 3:22
  SPEAKER_00: Osborne, I don't know that we would have topical Dapzone, for example.
• 3:26
  SPEAKER_03: Yeah, probably not.
• 3:28
  SPEAKER_03: And uh, you know, the doctor stuff, you know, we we can do away with the Dr.
• 3:33
  SPEAKER_03: Osborne.
• 3:34
  SPEAKER_00: Okay, we'll just say David from now on, gotcha.
• 3:38
  SPEAKER_00: All right.
• 3:39
  SPEAKER_00: Well, let's let's start with with that, okay, because I think that the topical Dapson, which was axone back in the day, and now it's uh generic, of course, but that was pretty revolutionary.
• 3:52
  SPEAKER_00: Nobody else could really figure out how to put dapsone into a topical formulation, but you decided to use kind of a novel uh penetration enhancer called Transcutol.
• 4:02
  SPEAKER_00: Can you go through that with us?
• 4:04
  SPEAKER_03: Absolutely.
• 4:05
  SPEAKER_03: So, you know, it's interesting.
• 4:07
  SPEAKER_03: So TransQtol as a solvent for personal care products uh was used a lot in the 80s and early 90s as uh for in the sunless tan products, you know.
• 4:22
  SPEAKER_03: So the tan in a bottle.
• 4:25
  SPEAKER_03: A lot of those were about 40% transcutol because it was a solvent that prevented streaking uh, you know, in the early days.
• 4:37
  SPEAKER_03: Um, you know, I never remember uh DHA, the dihydroxyacetone, uh, you know, it would just streak and then you'd have these striations and color as the you know the active bonded to the stratum corneum, and they fixed that with transcatol.
• 4:57
  SPEAKER_03: So really early when I was first at Virotex down in the woodlands, Texas, uh, you know, just a little south of you, uh, you know, away from the Yankees up here, uh the uh the um uh the sales rep from Gaffosay brought me a sample of transcutal.
• 5:21
  SPEAKER_03: And I formulated an over-the-counter cold sore product, a gel, Viractin gel, with transcutal.
• 5:29
  SPEAKER_01: Wow.
• 5:29
  SPEAKER_03: So then when it came time, you know, if it if if a person can, you know, put 40% transcutol covering their entire legs and arms and torso, I figured I could treat a cold sore with it safely, right?
• 5:46
  SPEAKER_03: And uh we launched that product, it was really you know over the counter.
• 5:51
  SPEAKER_03: Tetracaine was the active, you know, nothing extraordinary except that it used uh a novel solvent.
• 6:00
  SPEAKER_03: So when it came time to try to formulate Dapzone, uh it was on the shelf and it turned out to be an amazing solvent for Dapzone.
• 6:10
  SPEAKER_03: That was the key.
• 6:11
  SPEAKER_00: Because prior to that, right, Dapzone, the the we just didn't have the ability to really have a solvent for Dapzone.
• 6:18
  SPEAKER_00: We couldn't dissolve it in anything to make it a topical that worked well.
• 6:21
  SPEAKER_03: Yeah, and and you know, Dapzone is fascinating to you know, it's like a magic trick, it's like a uh, you know, a party trick for you know a kid's birthday party or something.
• 6:32
  SPEAKER_03: You can have like a scintillation vial full of the powdered drug dapsone, and you add 10 drops of transcutol, it all melts away.
• 6:45
  SPEAKER_00: Amazing.
• 6:46
  SPEAKER_03: Yeah.
• 6:47
  SPEAKER_00: And and dapsone kind of lends itself to acne, honestly.
• 6:50
  SPEAKER_00: It's antimicrobial as well as anti-inflammatory, but but there's something special with with transcutol as well, David.
• 6:58
  SPEAKER_00: I think I was reading in an article published a long time ago, that it almost acts as to form a reservoir effect in the stratum corneum and it limits systemic exposure as well.
• 7:10
  SPEAKER_03: Uh it it does.
• 7:12
  SPEAKER_03: And and transcutol, uh, when you uh because I wrote this review article when I retired from Tolmar, um, although I was working on Reflumolas kind of concurrent with retirement, uh but a luxury I, you know, a gift I gave myself was I I reviewed all the transcutol literature because there was this I don't know, uh you know schizophrenia, if you will, in the literature, because on one hand you'd say, oh, you know, transgital enhanced delivery 200 fold.
• 7:52
  SPEAKER_03: And then the next paper would say, oh, it it forms this depot in the stratum corneum, and so uh, you know, uh the drug was, you know, uh sustained release, topical sustained release technology.
• 8:08
  SPEAKER_03: And it never in my hands, it was great solvent.
• 8:15
  SPEAKER_03: It was really good at uh being able to deliver drugs that uh couldn't be dissolved in other formulations, uh, but I never saw it as this major enhancer.
• 8:32
  SPEAKER_03: I never really saw it just, you know, pound stuff through the stratum corneum like DMSO does.
• 8:39
  SPEAKER_03: Right.
• 8:40
  SPEAKER_03: You know, we understand DMSO.
• 8:42
  SPEAKER_03: Uh and so in that review article, it really depends on other things in the formulation because you're not going to get a tremendous amount of penetration enhancement unless you have other things like you know, uh propylene glycol.
• 8:59
  SPEAKER_00: Well, uh yeah, I mean, so it's interesting you say propylene glycol, right?
• 9:02
  SPEAKER_00: Because we have seen formulations with very high percentages of propylene glycol to enhance penetration.
• 9:07
  SPEAKER_00: Now, the downside of that is is irritation.
• 9:10
  SPEAKER_03: That's right.
• 9:11
  SPEAKER_03: And some people are allergic or they have some sort of special sensitivity to propylene glycol, and it just lights them up.
• 9:21
  SPEAKER_03: I'm one of those people, by the way.
• 9:23
  SPEAKER_03: So I don't tend to formulate.
• 9:25
  SPEAKER_03: You know, I did a lot of work with rogaine back in the 80s, uh, my first job.
• 9:30
  SPEAKER_03: Uh so I exposed myself to a lot of propylene glycol.
• 9:34
  SPEAKER_03: Uh, you know, somewhere in the mid-90s, um, I just couldn't use products that contain propylene glycol.
• 9:42
  SPEAKER_03: And so, you know, if you're a formulator and you're trying the 20 prototype formulations all day long, uh, if I had used propylene glycol for Zerif, for example, uh, you know, back of my hands would have been raw within two days of development.
• 10:00
  SPEAKER_03: So I don't use propylene glycol personally, so I don't formulate with it just because I can't tolerate it.
• 10:08
  SPEAKER_00: But it it has been used at higher concentrations in order to penetrate to enhance penetration.
• 10:14
  SPEAKER_03: Absolutely.
• 10:14
  SPEAKER_03: Absolutely.
• 10:15
  SPEAKER_00: And and I believe there's a I I believe you I think you were involved in this, the um formulation of a novel uh Clobetazole topical with uh with transcutol instead of propylene glycol.
• 10:28
  SPEAKER_00: Am I right about that?
• 10:29
  SPEAKER_03: Yeah, uh Clobex spray.
• 10:31
  SPEAKER_03: Um I did not formulate Clobex spray, but I was at uh Dow Pharmaceutical Sciences uh when that product was under development.
• 10:40
  SPEAKER_03: So I I wrote most of the CMC sections, defended it with the FDA and and uh uh yeah, worked a lot with Clobex.
• 10:48
  SPEAKER_00: Oh man.
• 10:48
  SPEAKER_00: And when I remember when Clobex came out, it really changed the way we treated psoriasis because it was one of those sprays you're supposed to still rub it in a little bit, but it really was such a great product.
• 11:00
  SPEAKER_00: Uh, you know, it's funny how the industry goes, right?
• 11:04
  SPEAKER_00: You formulate, you formulate, you formulate, you get these new formulations of these older compounds and they work better.
• 11:10
  SPEAKER_00: And then now we're trying to move away from steroids altogether, aren't we?
• 11:15
  SPEAKER_03: Uh we are, because we have safer alternatives.
• 11:19
  SPEAKER_03: And you know, both Zareve and VTama are great non-steroidals.
• 11:26
  SPEAKER_03: I mean, uh I don't know how you've found it in your practice, but um, you know, they're doing a lot of good for a lot of people.
• 11:33
  SPEAKER_00: Yeah.
• 11:34
  SPEAKER_00: So so what doc what uh sorry, I almost said doctor again, what David is referring to is so he he helped to formulate reflumolast, which is a PDE4 inhibitor, phospho diesterase 4 inhibitor, uh, which is an intracellular uh enzyme responsible for inflammation, essentially.
• 11:52
  SPEAKER_00: Um, and by inhibiting it, we can, it's shown to help reduce the uh the severity of psoriasis and also in uh starting to show it in eczema as well.
• 12:03
  SPEAKER_00: Um, and so reflumlast is a PDE4 inhibitor.
• 12:07
  SPEAKER_00: Right now we are in dermatology, we're very familiar with PDE4 inhibitors with both with the premolast and with uh chrysoborol.
• 12:14
  SPEAKER_00: Uh so uh permlast being the essentially the systemic agent PDE4 and chrysoborol being the topical.
• 12:22
  SPEAKER_00: And now we have the new PDE4 inhibitor, which is reflumolast.
• 12:27
  SPEAKER_00: And that, although it contains transcutol, there's there's another chemical, uh, there's another compound in there that that is kind of revolutionary in in terms of how it's being used in in medicine, right?
• 12:38
  SPEAKER_00: Right, David?
• 12:39
  SPEAKER_03: Yeah, the the emulsifier is a uh emulsifying wax blend uh with the trade name Crotofoss CES.
• 12:48
  SPEAKER_03: Uh now Crotofoss CES has been around, it was launched by Crota in the 90s uh for and it's used extensively in in the the you know um physical blocker sunscreens, the titanium dioxide and those sorts of sunscreens.
• 13:06
  SPEAKER_00: What why why in those?
• 13:07
  SPEAKER_00: Why was it used there?
• 13:09
  SPEAKER_03: Uh it makes a wonderfully stable emulsion.
• 13:14
  SPEAKER_03: If you if you have a cream in a tube that you're have with you on the beach and it gets heated up to you know 110 degrees, or you leave it in the car, you don't want it phase separating.
• 13:28
  SPEAKER_03: And Protofoss, uh you know, you could emulsify sand in Protofoss and keep it physically stable.
• 13:38
  SPEAKER_00: I mean, I've had that as part of my uh sunscreen as well, actually.
• 13:43
  SPEAKER_00: Unfortunately.
• 13:44
  SPEAKER_03: Yeah.
• 13:46
  SPEAKER_03: So but um and and and the other unique thing about Crotofoss, and this was known before we started formulating with it, was um it dominates the other ingredients as far as aesthetic feel.
• 14:03
  SPEAKER_03: So if you put mineral oil in Crotofoss or you put petrolatum in protofoss or you put a silicon oil in Crotofoss, uh the feel tends to be exactly the same.
• 14:15
  SPEAKER_02: Okay.
• 14:16
  SPEAKER_03: You know, so so you don't have to modify the ingredients to get an aesthetically pleasing product with Protofoss.
• 14:26
  SPEAKER_00: So so it's been around since the 1990s, but not really used in in medical uh formulations.
• 14:32
  SPEAKER_00: That's great.
• 14:33
  SPEAKER_00: And so what made you decide, okay, this is the right this is the right emulsifier to use for reflumolast?
• 14:41
  SPEAKER_03: Basically, it was the only emulsifier we could get a nice, cosmetically elegant, physically stable emulsion with the 25% transcutol that we have in our cream product, and our foam product for that matter.
• 14:59
  SPEAKER_03: But um you know, we we formulated the same concentration of transcutol as we did in the axone gel.
• 15:08
  SPEAKER_03: Okay, right uh because I knew that that was well tolerated and I knew it was well behaved, and so um, you know, I just stuck with an old friend when it came to formulating Cere.
• 15:24
  SPEAKER_03: Uh but that much transcutol, it's really hard to get a good stable emulsion because it tends to want to make a microemulsion, it wants to dissolve the interface, it wants to, you know, make a microemulsion.
• 15:38
  SPEAKER_03: And so um Chronos was really the only emulsifier uh robust enough to give us a good stable cream.
• 15:50
  SPEAKER_03: Okay and we tried.
• 15:52
  SPEAKER_03: We tried the other ones that were on the inactive ingredient database.
• 15:56
  SPEAKER_03: You know, keep in mind, haven't been a lot of new emulsifiers introduced into prescription products in many years.
• 16:05
  SPEAKER_00: Right, which which is why this is such a big deal.
• 16:08
  SPEAKER_00: Now, quick question what's so what's a microemulsion?
• 16:12
  SPEAKER_03: Uh a microemulsion is um they look more like a gel because they're not white.
• 16:21
  SPEAKER_03: Okay, the the the globule size is too small to reflect light.
• 16:26
  SPEAKER_03: Gotcha.
• 16:27
  SPEAKER_03: And so they they have a much different appearance.
• 16:30
  SPEAKER_03: Uh now people like to call them nano emulsions, uh, and it's all part of that nanotech um, you know, craze, if you will.
• 16:42
  SPEAKER_03: That's right.
• 16:43
  SPEAKER_03: Yeah.
• 16:43
  SPEAKER_00: Okay.
• 16:44
  SPEAKER_00: So it's really interesting, David.
• 16:45
  SPEAKER_00: You you have essentially taken two ingredients that were really well known in the cosmetic space and applied them to the medical space now with transcatalin crotopos.
• 16:56
  SPEAKER_03: Yeah, that's right.
• 16:57
  SPEAKER_03: It's uh it's kind of unusual because I only know one other person who's ever gotten a cosmetic ingredient onto the IID.
• 17:08
  SPEAKER_03: Um, and I'm blinking on his name, but he worked at Gauderma.
• 17:13
  SPEAKER_03: And uh when Epiduoforte was approved, uh the sepanils, which is a new gelling agent, uh pH-independent gelling agent, much easier to use than carbopol, uh, was introduced into the the IID.
• 17:28
  SPEAKER_03: And so um but those are the only three new drugs or three new incipients that have you know occurred, to my knowledge, in the topical space in the last 40 years.
• 17:43
  SPEAKER_00: Now, I know reflumolast is has been formulated into a foam, right?
• 17:48
  SPEAKER_00: As and we've used that in in several dermatitis trials, for example.
• 17:53
  SPEAKER_00: Um, did did you was Crotofos used in the foam formulation or was Transcutoly used in the foam formulation as well?
• 17:59
  SPEAKER_03: Yeah, it's uh you know, I I love telling this story because you know, if you're developing a foam, first thing you do is you take the cream, you put it in a can, you crimp on the valve, and you add some propellant, you shake it up, and then you're prepared for disappointment because it never works.
• 18:20
  SPEAKER_02: Okay.
• 18:21
  SPEAKER_03: Right.
• 18:22
  SPEAKER_03: With Zareve, we did that and it worked.
• 18:27
  SPEAKER_03: Okay, now now we got some sputtering, okay, so that meant that the the what we call the foam concentrate was too thick.
• 18:37
  SPEAKER_03: But as soon as we thinned the product down, and and you know, for scalp, you don't need a lot of petrolatum.
• 18:44
  SPEAKER_03: So we reduced the amount of petrolatum and isopropyl palmitate, the moisturizers and the cream formulation, and that allowed us to reduce the amount of Crotofos, right?
• 18:54
  SPEAKER_03: Because you don't need as much emulsifier if you're not emulsifying as much oil, right?
• 19:00
  SPEAKER_03: And uh and that that's the product.
• 19:04
  SPEAKER_03: So it's just add per pellet, no additional excipients, uh just a reduction in the amount of three of the excipients.
• 19:13
  SPEAKER_00: And again, no need for propylene glycol again.
• 19:15
  SPEAKER_03: No, no ethanol, no propylene glycol.
• 19:18
  SPEAKER_03: Uh you know, my first experience with an alcoholic foam was back in the 90s.
• 19:23
  SPEAKER_03: Um did a surgical hand scrub that contained chlorhexidine as an active.
• 19:30
  SPEAKER_03: And um, you know, but those alcoholic foams uh are really well known.
• 19:37
  SPEAKER_03: You know, that that was the um you know the you know the foam products, but but they're they tend to be drying and you know, and then it the next evolution was to remove the alcohol from from the foams and have these moisturizing foams that uh you know have recently been uh introduced with minacycline.
• 20:03
  SPEAKER_03: Um and and but our our foam is you know completely different system because no one else has ever used Crotofoss in a uh NDA foam.
• 20:16
  SPEAKER_00: Got it.
• 20:17
  SPEAKER_00: So just to give us some insight, David, I'm just thinking about Transcutal and Crotofoss.
• 20:22
  SPEAKER_00: Now, those were not developed by by you or or you know at Dow, for example, or at uh Arcutis.
• 20:31
  SPEAKER_00: Those are actually produced by a third-party company that kind of brings them to the market.
• 20:36
  SPEAKER_00: What what are those companies called?
• 20:38
  SPEAKER_00: And and how do you think of them in terms of their place in the industry?
• 20:42
  SPEAKER_03: Well, there are suppliers, uh, are the incipient suppliers, but when you think of Crota, uh they make lots, you know, they have hundreds of cosmetic items.
• 20:57
  SPEAKER_03: Crota's really big.
• 20:59
  SPEAKER_03: Uh gaffis are very old, you know, they've been in existence over a hundred years.
• 21:06
  SPEAKER_03: Uh they originally were doing plant extracts for the French perfume industry.
• 21:14
  SPEAKER_03: So they grow fields of lavender and pick all the flowers and extract the essential oils and sell them to perfumers.
• 21:23
  SPEAKER_03: Um so you know, these these are well-established companies that provide uh solvents and recipients to to pharma.
• 21:33
  SPEAKER_00: And so they have they have their own formulation scientists and chemists who are developing these novel emulsifiers and solvents for the industry.
• 21:43
  SPEAKER_03: Uh yes, although you know, I don't know how many new emulsifiers are being worked on now.
• 21:53
  SPEAKER_03: Um because when you you know look at the cosmetic industry.
• 22:01
  SPEAKER_03: You're not really confined for what you put in a cosmetic.
• 22:06
  SPEAKER_03: And you're not really confined, at least up until a couple years ago.
• 22:11
  SPEAKER_03: I'm not totally familiar with the most recent laws for over-the-counter products, but you're not confined in what you put in there.
• 22:19
  SPEAKER_03: It's it's really only your personal liability and corporate liability.
• 22:24
  SPEAKER_03: So people are very conservative, right?
• 22:28
  SPEAKER_03: Um but that's not an FDA requirement.
• 22:33
  SPEAKER_03: It's just they don't want to get sued.
• 22:35
  SPEAKER_03: You know, in the old days, when you do an OTC product, all you'd have to do is is file what the active was and that you conform to the monograph and you weren't going to say anything outside the monograph.
• 22:50
  SPEAKER_03: You know, that was you didn't even have to put the components.
• 22:55
  SPEAKER_03: Right.
• 22:56
  SPEAKER_03: And the only other piece of information you had to put was who the attorneys would contact if you were the lawsuit was brought against you.
• 23:08
  SPEAKER_03: Who at the company was responsible to pay if you damage someone.
• 23:15
  SPEAKER_00: Wow.
• 23:16
  SPEAKER_00: So, you know, and and when we're talking about monographs, we're talking about FDA monographed ingredients, those are those ingredients that have been approved by the FDA to be used in over-the-counter products that that do have active um abilities to change structure function of the skin.
• 23:33
  SPEAKER_00: Um so, for example, if we're talking about acne, we're thinking about salicylic acid or benzyl peroxide, um uh resortinol, sulfur, the the the compounds that you commonly see in the over-the-counter acne space are these FDA monographed ingredients.
• 23:48
  SPEAKER_00: Um, and that's what we're talking about when we talk about monographs, right, David?
• 23:52
  SPEAKER_03: That's correct.
• 23:53
  SPEAKER_00: Okay.
• 23:53
  SPEAKER_00: All right, great.
• 23:54
  SPEAKER_00: So I just wanted to kind of we're running a little bit short on time as we always do with these.
• 23:59
  SPEAKER_00: Um it's unfortunate.
• 24:01
  SPEAKER_00: But, you know, when we think about Zareve, and we touched on this a little bit earlier, but it's it's striking to me how we have such great non-steroidal uh topicals like Zareve, um, like Vitama, you know, these non-steroidals, but the the dermatologic kind of industry really hasn't adopted them to the point where I think they should have.
• 24:25
  SPEAKER_00: You know, I I see these as replacing steroids.
• 24:29
  SPEAKER_00: I I don't think these are the step downs from using a steroid initially to quell the fire and then keeping things under control with these.
• 24:36
  SPEAKER_00: I really would like to see these being used first line, as I'm sure would the companies.
• 24:40
  SPEAKER_00: Any insight as to why why that prescribing behavior hasn't changed or or or what we need to know that maybe that that education just isn't being delivered or or just not being heard, maybe well, first of all, I absolutely agree with you.
• 24:56
  SPEAKER_03: I I think the the split, you know, was like 90% steroids, 10% non-steroidals.
• 25:03
  SPEAKER_03: Right.
• 25:03
  SPEAKER_03: And that should be reversed.
• 25:05
  SPEAKER_03: Now that you know, there will be the occasional patient uh where their psoriasis or their inflammatory skin condition is you know on a safe spot and you really need the fire extinguisher, you really need uh, you know, because it for whatever reason, you know, as a clinician, as a physician, you're gonna know which patients need COVEX spray, for instance, right?
• 25:32
  SPEAKER_03: Yeah, um, but that should be the minority of patients.
• 25:37
  SPEAKER_03: Uh so you know, I think that there are in all fields, there are early adopters and there are people that will just wait and see.
• 25:56
  SPEAKER_03: Right.
• 25:57
  SPEAKER_03: And, you know, these non-steroidals, these really excellent products, you know, it's still been less than a year.
• 26:06
  SPEAKER_00: Right.
• 26:06
  SPEAKER_00: That's true.
• 26:07
  SPEAKER_00: That's true.
• 26:08
  SPEAKER_00: We could still think about it as an early adoptive phase to some of these products.
• 26:11
  SPEAKER_00: I mean, I think what's important for people to realize is that, you know, look, Zareve is is not Chrysoborol, right?
• 26:19
  SPEAKER_00: It's a totally different PDE4 inhibitor molecule.
• 26:22
  SPEAKER_00: It the formulation doesn't include propylene glycol at all, whereas the other formulation with the Chrysoborol does, um, which may have led to some of the stinging and burning that we've experienced with that drug, and we just don't see with Zareve.
• 26:36
  SPEAKER_00: Um with V with Vitama, we've got a novel and you know aeryl hydrocarbon receptor agonist.
• 26:43
  SPEAKER_00: Again, totally new mechanism of action, not seen in dermatology.
• 26:47
  SPEAKER_00: Elegant formulation as well.
• 26:49
  SPEAKER_00: Um, you know, perhaps people a little bit wary because it's a novel for novel mechanism of action.
• 26:55
  SPEAKER_00: I'm not sure.
• 26:56
  SPEAKER_00: But but I do think that the word needs to get out that we really need to consider as a specialty to try and move away as much as we can from topical steroids.
• 27:04
  SPEAKER_00: But I could see you, what what else would you like to say about that, David?
• 27:07
  SPEAKER_03: Oh, uh I'm just absolutely agreeing.
• 27:10
  SPEAKER_03: And I would think that if someone's been in practice a long time, you know, steroids are their old friend, right?
• 27:19
  SPEAKER_03: They've used it successfully.
• 27:21
  SPEAKER_00: Yeah, changing prescribing habits is is difficult.
• 27:24
  SPEAKER_00: I I'm very, very guilty of that in terms of trying to change my prescribing habits.
• 27:30
  SPEAKER_00: You kind of you kind of lean into your old friend in terms of trying to get someone better quickly.
• 27:36
  SPEAKER_00: Um, and then when you have something new, you've got to trust it, you know, because as as physicians, as providers, we need to trust that what we are prescribing is going to work.
• 27:46
  SPEAKER_00: And so with these novel compounds, you kind of have to gain that trust slowly over time.
• 27:51
  SPEAKER_00: And maybe that's what we're seeing is just kind of that slow uptake in regards to the changing of the practice patterns and the trust that needs to uh be imbued in these products over time.
• 28:02
  SPEAKER_03: If that is true, then you're we're gonna see a really rapid increase in uptake because you know you you especially with Zareve, you know, I I just know Zareve.
• 28:18
  SPEAKER_03: Um you try it on a handful of patients, uh you're gonna be really pleased with how those patients do.
• 28:29
  SPEAKER_03: But it will take you know four to six months, maybe before you see them back, you know, before you have that follow-up.
• 28:35
  SPEAKER_02: That's true.
• 28:35
  SPEAKER_02: We're all busy.
• 28:36
  SPEAKER_03: And so it hopefully will be a hockey stick for for all of us, non-steroidal folks, in the in the coming months, and and we'll just see, you know, because it's all about patient care.
• 28:49
  SPEAKER_03: What you you want to do the best for your patients.
• 28:52
  SPEAKER_03: I want my products to do the best for your patient.
• 28:54
  SPEAKER_03: Um, we want all products that are doing the best for the patients.
• 29:00
  SPEAKER_00: I think that's a great point to end on.
• 29:02
  SPEAKER_00: So uh everyone, this is the Skin Care Confidential Podcast.
• 29:05
  SPEAKER_00: I am Dr.
• 29:05
  SPEAKER_00: Ted Lane.
• 29:06
  SPEAKER_00: We have just had the wonderful experience of interviewing uh Dr.
• 29:10
  SPEAKER_00: David Osborne, uh, a formulator, currently the chief technical officer with Arcutis.
• 29:15
  SPEAKER_00: Uh, prior to that, has worked with Dow and others.
• 29:18
  SPEAKER_00: Um, you don't forget to uh download our podcast.
• 29:22
  SPEAKER_00: Please, please subscribe, please share Skincare Confidential with your network as well.
• 29:27
  SPEAKER_00: Um, we are getting great feedback from our listeners, and we certainly thank everyone for their support.
• 29:33
  SPEAKER_00: Um, we're we're doing this out of the goodness of our hearts, really.
• 29:38
  SPEAKER_00: We just really enjoy it.
• 29:39
  SPEAKER_00: Batty and I just enjoyed this so much in speaking to great people like like David here.
• 29:44
  SPEAKER_00: So um, with that, I thank you and uh stay tuned for more skincare confidential episodes coming every two weeks.
• 29:51
  SPEAKER_00: Thank you.