Daily routine for acne patients: the importance of a specific cleanser

For patients with acne, cleansing is an essential part of the treatment; it aims to gently remove surface dirt, sweat, and excessive sebum without irritating or drying the skin.^1,2

A wide range of cleansers

Several types of cleansers with different mechanisms of action are available (surfactants, makeup removers, astringent cleansers, and abrasive cleansers).^1,2

Surfactants are the most important group; they act by decreasing surface tension and are classified as anionic, cationic, ampholytic, and nonionic.²

Surfactants for acne are generally available as soaps, cleansing bars, liquid gel or foam cleansers, superfatted soaps and lipid-free cleansers.²

They may be enhanced with active substances such as sebum-controlling, antimicrobial, anti-inflammatory, corneolytic, and soothing agents.²

Which type of cleanser should be chosen?

A nonionic, liquid cleanser or cleansing bar with good rinsability should be preferred for patients with acne.¹

Mild cleansers are also recommended to avoid aggravating the irritating effects of some medical treatments.³

The ideal cleanser for acne-prone skin should be:

• With a pH close to physiological pH (5.5 for the skin)^1,2
• Non-irritating^1,2
• Non-allergenic^1,2
• Soap-free
• Alcohol-free
• Fragrance-free
• Non-comedogenic^1,2

Beyond cleansing, action on seborrhea and adherence

The regular daily use of facial cleansers designed for oily to acne-prone skin has been shown to improve seborrhea without causing rebound sebum overproduction after treatment discontinuation.²

Finally, the use of cleansers is one of the key factors with a positive effect on adherence in patients with mild to severe acne.⁴

Cleansers for acne: recommendations for health care professionals²

Indications:

• A cleanser should be prescribed to all acne patients, with or without ongoing treatment; it may also be considered after treatment discontinuation and during the summer months.
• Benzoyl peroxide cleansers are better suited to patients using systemic and/or topical antibiotic treatments, and in those who cannot tolerate other BPO topical products.

To be considered

• Always discuss cleansing habits with patients.
• Check for aggressive cleansers used by patients.
• Discourage the use of natural soaps and cleansers containing ground fruit pits.
• In case of concomitant use of BPO creams or gels, patients should be advised of a possible irritant and cumulative effect and to avoid sun exposure.
• In case of xerosis from retinoid treatments, recommend a mild cleanser containing soothing agents.