Choosing the Right Partner: Complementing Prescription Acne Medication With Over-the-Counter Cleansers and Moisturizers

Background: Acne is the most common dermatological disorder. An impaired barrier function in acne vulgaris has been reported, as well as decreased amounts of epidermal ceramides. Also, many of the systemic and topical medications prescribed for the treatment of acne exacerbate these skin barrier disruptions and can lead to irritation and dry skin conditions. Aim: The review explored the importance of maximizing adjunctive skincare, such as over-the-counter products for managing acne and avoiding adverse effects. Methods: A literature review was conducted and included clinical acne guidelines, clinical studies, and review articles on acne prevention, treatment, and maintenance. Searches were made in PubMed and Google Scholar for English-language literature published between Jan 1, 2010, and Apr 1, 2020. Two clinicians manually reviewed selected publications. Results: Seventy-four articles were included in the analyses. A variety of specialized cleansers and moisturizers are available as suitable adjunctive therapies for acne-prone skin. Lipid-free cleansers were found to be the most appropriate type of cleanser for acne-prone skin as they were associated with a low risk of skin irritation, and a near-physiological stratum corneum pH. Moisturizers typically included ingredients such as humectants, emollients, oil absorbers, and those with anti-inflammatory and/or barrier replenishing properties. Given the various adjunctive products available, decision frameworks were created for clinicians to use when selecting over-the-counter cleansers and moisturizers for acne-prone patients. Conclusion: Informing clinicians about skin barrier dysfunction in acne and the benefits of adjunctive skincare may help them to choose the right product(s) to complement prescription therapy.