Abstract
Calcitonin gene-related peptide (CGRP) is a neuropeptide involved in neurogenic inflammation and vasodilation, playing a key role in the pathophysiology of both migraines and inflammatory skin conditions, including acne and rosacea. This case report presents a 30-year-old woman with a long-standing history of cystic acne, which persisted despite numerous treatments, including antibiotics and hormonal therapy for polycystic ovary syndrome (PCOS). The patient was prescribed rimegepant, a CGRP receptor antagonist, for migraine management. Within four weeks of starting rimegepant, the patient experienced significant improvement in her cystic acne, particularly on her chin, which had been the most affected area. The painful lesions cleared almost entirely, and the patient reported a reduction in both cosmetic and physical discomfort. The cystic acne did not recur, except for a minor episode during a period of high stress. This case suggests that CG RP inhibition may have potential therapeutic benefits for inflammatory skin conditions such as cystic acne. The mechanism may involve modulation of neurogenic inflammation, which plays a role in the development of acne. CGRP's involvement in sebaceous gland activity and its inflammatory effects make it a promising target for acne treatment. Further studies are needed to explore the potential dermatological applications of CG RP antagonists like rimegepant in patients with acne and other inflammatory skin disorders. This case contributes to the growing body of evidence suggesting that CG RP inhibitors could offer benefits beyond migraine treatment, highlighting a novel therapeutic avenue for skin health management.