Dr. James Fulton, co-creator of Retin-A and acne researcher, dies

Dr. James E. Fulton Jr., the Key Biscayne dermatologist who assured pimply-faced Baby Boom teenagers that chocolate didn’t cause zits — and later armed that same generation with Retin-A to battle lines and wrinkles — died July 4 at Mercy Hospital.

He was 73 and succumbed to colon cancer, said his wife and business partner, chemist Sara Fulton.

In 1990, the Fultons co-founded the Vivant Skin Care line based on vitamin A therapies that James Fulton patented. The company makes 30 skin-care products in the $15 to $100 range, using only U.S.-made ingredients, at an FDA-approved plant in Miami Lakes.

Fulton’s 2001 book, Acne Rx: What Acne Really Is And How To Eliminate Its Devastating Effects, earned him a spot on television’s “The View.”

A one-time University of Miami Miller School of Medicine faculty member, Fulton stayed on as volunteer faculty to the end of his working life, in June.

He pioneered cosmetic surgical procedures to reduce acne scars, and fat transfer procedures for breast augmentation.

His wife believes he was the first dermatologist to include an aesthetician on his medical team, a practice that colleagues initially scorned, then widely imitated.

Born in Ottumwa, Iowa, on Feb. 25, 1940, Fulton grew up in California. He suffered from acne, which led him to research the condition and develop ways to fight it.

In the introduction to his book, he spoke of “both anguish and joy’’ in tackling the topic.

“The message is basic. While acne is a complicated, mysterious and devious disease, the treatment is remarkably simple and control is finally possible. That is the joy,’’ he wrote.

“The anguish lies in the personal memories I dislodged as I wrote...The medical establishment miserably failed me in my search for a treatment that would work...My professional obsession has been to discover methods which though too late for me personally, would save others from the scars of acne,’’ both physical and emotional.

Fulton was a fellow of both the American Academy of Cosmetic Surgery and American Academy of Dermatology, and was board certified in both specialties. He saw patients at Flores Dermatology in Coral Gables and delivered free care to children at His House Children’s Home.

Fulton, whose father had been a Cracker Jack company executive, swam competitively at Tulane University, where he earned undergraduate and medical degrees.

Following medical school, Fulton came to Miami at the invitation of Dr. Phillip Frostand earned a doctorate in biochemistry from UM in 1972. He and UM’s Dr. Harvey Blank developed benzoyl peroxide gel (Panoxyl®) and topical erythromycin (E-Gel®).

As a University of Pennsylvania researcher in 1969, Fulton developed tretinoin (Retin A®) with Dr. Albert M. Kligman. The universities held the patents, which they licensed to pharmaceutical companies.

That year, Fulton, Kligman and co-author Dr. Gerd Plewig published The Effect of Chocolate on Acne Vulgaris, in the Journal of the American Medical Association.

They detailed a study on 65 subjects with moderate acne, some of whom were given candy bars “containing 10 times the amount of chocolate in a typical bar, or an identical-appearing bar which contained no chocolate....Counting of all the lesions on one side of the face before and after each ingestion period indicated no difference between the bars.’’

They concluded that “this excessive intake of chocolate and fat did not alter the composition or output of sebum. A review of studies purporting to show that diets high in carbohydrate or fat stimulate sebaceous secretion and adversely affect acne vulgaris indicates that these claims are unproved.’’

“He must have been the most beloved dermatologist in the world,’’ Sara Fulton said.

Dr. Lawrence Schachner, chief of UM’s Department of Dermatology and Cutanous Surgery, said that chocolate’s role in acne remains “controversial,’’ but he called Fulton “a very important early contributor to acne therapies [who] most sincerely cared about his patients. He was a unique, interesting individual who really demonstrated innovating thinking.’’

Retin-A, he said, became “a mainstay of treatment.’’

Fulton “was a lifelong learner,’’ said Schachner. “He was still coming to conferences to the last week, taking notes, participating, and he loved to teach.’’

Sara Fulton met her husband at Penn, where she was teaching anatomy to nursing students. She said she saw him in an elevator then faked a rash so she could get an appointment to see him.

They married Feb. 2, 1970 “at lunchtime, then we went back to the lab to do research,’’ Sara Fulton recalled. “We had such a fabulous relationship. We worked together almost every day.’’

They raised four children in Newport Beach, Calif., where they maintained a home from 1975 to 2004.

They launched a 12-office chain of Acne Healthcare Clinics in the 1970s on U.S. 1 across from the UM campus, where they “developed and manufactured a line of patented skin care products under the AHC and Face Up brands,’’ according to a company statement.

They founded Vivant in California in 1990, relocating to Florida in 2000. Also in 1990, James Fulton opened JEF Medical Group, a cosmetic surgery and dermatology practice “where he pioneered fat transfer and laser surgery and was the first to use hyperbaric oxygen chambers for post-surgical recovery,’’ the statement says.

South Miami dermatologist Dr. Peter H. Wendschuh was a UM resident who studied with Fulton and remained a friend.

Fulton’s “dedication to the problem of acne was total,’’ Wendschuh said. “He never stopped working in it...He was a good cosmetic surgeon and he helped a lot of people who suffered with acne scars live a better life.’’

In addition to his wife, Fulton is survived by daughters Kelly Fulton-Kendrick, Vivant’s CEO, and Susan Fulton-Arregui, of Miami; sons James E. Fulton III, of Miami, and George J. Fulton, of Reston, Va.

A memorial service will be held 7 p.m. July 17 at St. Stephen Episcopal Church, 2750 McFarland Rd, Coconut Grove.

In lieu of flowers, the family suggests memorial donations to the Dr. Hsia Memorial Fund, University of Miami Miller School of Medicine, Department of Dermatology, 1600 NW 10th Ave., Suite 2023-A, Miami, FL 33136.

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