BACKGROUND
Acne is the most common dermatological disorder.1 Psychological and emotional distress due to acne, including poor self-esteem, social anxiety, depression, and suicidal ideation have been reported in various studies.2,3,4 Acne is a complex, multifactorial disease, and its pathophysiology is incompletely elucidated. An impaired barrier function in acne vulgaris has been reported, as well as decreased amounts of ceramides.5 The structural and functional integrity of the stratum corneum is highly dependent on adequate hydration in the skin barrier. However, in acne-prone skin, barrier integrity is compromised both functionally (sebum excretion is higher, sebaceous glands are larger and subclinical inflammation is present) and via ultrastructural properties (filaggrin expression is enhanced, free fatty acids are reduced, linoleic acid, free sphingosine, and total ceramides are altered).6
Many of the systemic and topical medications prescribed for the treatment of acne, such as retinoids, antibiotics, and benzoyl peroxide, are associated with skin barrier alteration.7 This, in turn, can cause irritation and dry skin conditions.8 These unwanted effects can reduce adherence to treatment, and therapeutic outcomes.8,9 Over-the-counter (OTC) nonâ€comedogenic cleansers and moisturizers have been used successfully to reduce skin irritation.9 However, some of these products, such as those with a high pH, have been shown to interfere with the efficacy of topical treatments for acne.8 Managing the irritation potential of topical acne medications through the selective use of adjunctive, OTC skincare is an important strategy for improving treatment adherence and outcomes.
Aim of review
A literature review was conducted to explore clinical insights into skin barrier dysfunction in acne and the role of cleansing and moisturizers as adjunctive to prescription acne treatment. Informing health care providers about skin barrier dysfunction in acne and the benefits of adjunctive skincare may help them to choose the right OTC product(s) when complementing prescription therapy.
Many of the systemic and topical medications prescribed for the treatment of acne, such as retinoids, antibiotics, and benzoyl peroxide, are associated with skin barrier alteration.7 This, in turn, can cause irritation and dry skin conditions.8 These unwanted effects can reduce adherence to treatment, and therapeutic outcomes.8,9 Over-the-counter (OTC) nonâ€comedogenic cleansers and moisturizers have been used successfully to reduce skin irritation.9 However, some of these products, such as those with a high pH, have been shown to interfere with the efficacy of topical treatments for acne.8 Managing the irritation potential of topical acne medications through the selective use of adjunctive, OTC skincare is an important strategy for improving treatment adherence and outcomes.
Aim of review
A literature review was conducted to explore clinical insights into skin barrier dysfunction in acne and the role of cleansing and moisturizers as adjunctive to prescription acne treatment. Informing health care providers about skin barrier dysfunction in acne and the benefits of adjunctive skincare may help them to choose the right OTC product(s) when complementing prescription therapy.
