NECASA I: A Practical Algorithm Integrating Skincare in the Management of Acne Patients in the Nordic European Countries

ABSTRACT

Background: Acne vulgaris is a multifactorial dermatosis primary of the face and trunk. Erythema, pruritus, and xerosis are frequent adverse effects of first-line acne treatment and, if not appropriately counseled and managed, can exacerbate, leading to regimen nonadherence and poor outcomes.

Methods: A panel of six dermatologists (five from the Nordic European Countries and one from the UK) employed a modified Delphi method and reached a consensus on a practical acne treatment and maintenance algorithm integrating skincare based on the best available evidence, and the panel's clinical experience, and opinions.

Results: The Nordic European Countries Acne Skincare Algorithm (NECASA) recommends integrating skincare and nonprescription acne treatment into acne regimens, addressing the relative lack of standardized guidance on their use as mono or adjunctives to acne treatment. The algorithm uses stratification by acne subtype and discusses management approaches per type of acne (comedonal, papulopustular, and nodulocystic acne), severity (mild to moderate and severe), and maintenance treatment. Skincare monotherapy may reduce acne lesions and maintain clearance in patients with mild acne. Adjunctive skincare may enhance the efficacy and improve tolerability of acne treatment, reduce pigmentary alterations, and improve skin barrier function.

Conclusions: The NECASA algorithm may serve as a roadmap for integrating skincare in managing acne patients and tailoring acne treatment to improve adherence and tolerance to treatment and patient outcomes.