ACNE TREATMENT.

Even though treatment modalities based on acne severity are well established, acne is considered a chronic and relapsing inflammatory disease that can vary in severity,and may require long-term management.
Increased and altered sebum production is a key factor in acne pathogenesis but very few topical products have been proven to target abnormal sebum production.⁽³⁾;
Conventional acne treatment presents several challenges such as intolerable side effects and antibiotic resistance.

Skin care is integral in reducing and preventing Acne Vulgaris (AV) lesions and maintaining healthy skin.

Topical dermocosmetics play a multiple role in the pathogenesis of acne:

_1. Synergistic effect: target another pathogenic factor and/or improve the efficacy of another treatment
_2. Management of side effects: alleviate side effects of other treatments and potential skin barrier defects
_3. Prevention and maintenance: prevent appearance of new lesions⁽²⁾

Dermocosmetics include skin cleansers, topical sebum ¬controllers, skin antimicrobial/anti-inflammatory agents, moisturisers, sunscreens, and camouflage products.

Preparations for topical application are available as various formulations, including creams, gels, lotions, solutions and washes.⁽⁴⁾

Mattifying agents found in topical sebum-control products have been shown to absorb and retain sebum, correcting the oily, or shiny appearance of the skin as well as decrease the risk of formation of comedones and inflammatory acne lesions.⁽⁵⁾ 

Cleansers are used to remove makeup, oil, dirt, dead skin cells, and bacteria and are useful for acne patients.⁽⁵⁾

A cleanser may be used as part of a skin care regimen together with other dermocosmetics.⁽⁵⁾

Dermocosmetic moisturisers can overcome the side effects of dryness and stinging caused by induction or maintenance therapy.⁽⁵⁾

Moisturisers specifically made for AV therapy were found to improve the tolerability by decreasing the dryness and stinging sensation associated with barrier disruption, thus improving compliance to treatment.⁽⁵⁾

Sunscreens are strongly recommended in acne patients at high risk of postinflammatory hyperpigmentation and in patients who already have signs of postinflammatory hyperpigmentation.⁽⁵⁾

Cosmetic camouflage or corrective maquillage aims to disguise disfiguring skin lesions by improving the appearance of the skin. They can be used to contour and correct pigment abnormalities, control oil, moisturize, protect against UV light, increase absorption of acne treatment, improve the skin barrier, and improve personal well-being.⁽⁵⁾

Topical therapy is based on the type and severity of acne.

Mild acne is often treated with topical retinoids, or a variety of diverse treatments such as azelaic acid, salicylic acid and benzoyl peroxide.

Mild to moderate inflammatory acne can be treated with topical anti-inflammatory agents as well as topical antibiotics.⁽⁴⁾

^{(1) The Psychosocial Impact of Acne Vulgaris Hazarika N, Archana M.}

^{(2) The role of topical dermocosmetics in acne vulgaris. E. Araviiskaia, B. Dreno}

^{(3) Not all acne is acne vulgaris. Gollnick HP1, Zouboulis CC.}

^{(4) Treatment Modalities for Acne Lizelle Fox, Candice Csongradi, Marique Aucamp, Jeanetta du Plessis, and Minja Gerber*
Yogeshvar Kalia, Academic Editor and Diego Muñoz-Torrero, Academic Editor}

^{(5) Meeting the Challenges of Acne Treatment in Asian Patients: A Review of the Role of Dermocosmetics as Adjunctive Therapy.
Goh CL1, Noppakun N2, Micali G3, Azizan NZ4, Boonchai W5, Chan Y6, Cheong WK7, Chiu PC8, Etnawati K9, Gulmatico-Flores Z10, Foong H11, Kubba R12, Paz-Lao P13, Lee YY14, Loo S15, Modi F16, Nguyen TH17, Pham TL18, Shih YH19, Sitohang IB20, Wong SN21.}