Adjunctive therapy for acne in daily practice: Key issues for effective patient management

  • 20min
  • May. 2022
  • Supported by
    • La Roche-Posay

Acne and many of its treatments (i.e. benzoyl peroxide, topical retinoids, and oral isotretinoin) can impair the stratum corneum (SC) permeability barrier.1



Why do we recommend dermocosmetics as adjuvant to therapy to acne patients?


Although much more research is needed on the structural and functional integrity of the SC and epidermal barrier functions inherent to acne-prone skin, there is some evidence of SC permeability impairment innate to acne and/or the inflammation that occurs in association with acne.1

In addition, studies show a rapid and dramatic improvement in QoL scores when used properly in addition to other therapies. Because improvement in QoL is related to patient satisfaction and compliance with medical treatment, make-up at the onset of treatment in specific cases may help increase patient satisfaction and yield improved clinical results.2

In addition:

  • Many of the topical medications used to treat acne, and some of the vehicles used, may impair the SC permeability barrier either via an innate mechanism of action and/or by inducing cutaneous irritation.
  • Oral isotretinoin impairs the SC permeability barrier by causing corneocyte dyscohesion and could also induce marked sebo-suppression and alteration in the cutaneous microbiota.1

Numerous side effects caused by recommended acne medications as skin dryness, erythema, scaling, stinging or burning, itching, etc. may lead to non-adherence and so treatment failure.2,3

Appropriate dermocosmetics such as cleansers, skincare, may improve tolerance and also provide adjunctive value to the medical treatments.1,2,3



What specific benefits can an acne patient expect from dermocosmetics?


Adjunctive therapy is an opportunity for a physician to recommend a comprehensive treatment to improve their patients' condition, bringing many benefits:

  • Maintaining and supporting the efficacy of drug treatments
  • Preventing acne lesions recurrence
  • Reducing severity of side effects of over-drying treatments
  • Increasing compliance
  • Ultimately improving patients' quality of life



How do we choose an effective dermocosmetic product for adjunctive therapy?


Its efficacy has been demonstrated in clinical trials following gold standard protocols:

  • Efficacy and safety evaluated clinically, under realistic conditions, in patients with skin conditions
  • Double-blind randomized studies vs. placebo, excipient, or other referent product
  • Clinical studies carried out by independent medical or scientific teams.

The results of clinical trials have been published in internationally recognized journals or presented at several scientific congresses.

Specific information is available for its use:

  • Clearly identified ingredient (full labelling)
  • Safe formulation charter
  • Implementation of cosmetovigilance.

Bibliography

  1. Del Rosso J.Q. The Role of Skin Care as an Integral Component in the Management of Acne Vulgaris Part 1: The Importance of Cleanser and Moisturizer Ingredients, Design, and Product Selection. J Clin Aesthet Dermatol. 2013;6(12):19–27.
    Link to free full text
  2. Goh C.L., Noppakun N., Moccali G., et al. Meeting the Challenges of Acne Treatment in Asian Patients: A Review of the Role of Dermocosmetics as Adjunctive Therapy. J Cutan Aesthet Surg. 2016;9(2):85–92.
    Link to free full text
  3. Lynde C. W., Andriessen A., Barankin B., et al. Moisturizers and Ceramide-containing Moisturizers May Offer Concomitant Therapy with Benefits. J Clin Aesthet Dermatol. 2014;7(3).
    Link to free full text
  4. Solomon B.A., Shalita A.R. Effects of detergents on acne. Clin Dermatol 1996;14(1):95–9.
  5. Munehiro A., Murakami Y., Shirahige Y., et al. Combination effects of cosmetic moisturisers in the topical treatment of acne vulgaris. J Dermatolog Treat. 2011;23(3):172–6.
    Link to abstract
  6. Feldman S.R., Chen D.M. How patients experience and manage dryness and irritation from acne treatment. J Drugs Dermatol. 2011;10(6):605–8.
    Link to abstract
  7. Draelos Z.D. Therapeutic moisturizers. Dermatol Clin. 2000;18(4):597–607.
    Link to abstract
  8. Lynde C.W. Moisturizers: what they are and how they work. Skin Therapy Lett. 2001;6(13):3–5.
    Link to abstract
  9. Dreno B. Abstract Dermatologie 2008;531.
  10. Matsuoka Y., Yoneda K., Sadahira C., et al. Effects of skin care and makeup under instructions from dermatologists on the quality of life of female patients with acne vulgaris. J Dermatol. 2006 Nov;33(11):745–52.
    Link to abstract
  11. Solomon B.A., Shalita A.R. Effects of detergents on acne. Clin Dermatol. 1996 Jan–Feb;14(1):95–9.