INTRODUCTION
Acne vulgaris is a chronic inflammatory skin disease of the pilosebaceous unit, characterized by permeability barrier dysfunction and reduced ceramide levels in the stratum corneum.1,2 Unfortunately, many acne medications, such as retinoids and benzoyl peroxide (BPO), cause irritation as a side effect, which can worsen underlying disease-related barrier issues.3 This irritation can be measured as increased transepidermal water loss (TEWL) and decreased stratum corneum hydration. Functionally, this irritation can result in activation of the innate immune system with subclinical inflammation and proteomic changes, such as increased filaggrin expression and decreased free fatty acid and linoleic acid production.4 Thus, the barrier alterations inherent in acne may be magnified by irritating topical treatments, decreasing patient adherence, and hampering disease resolution.5
Carefully formulated and selected adjunctive skincare products can minimize additive barrier damage. A moisturizer effective in acne medication-induced irritation must provide occlusion to control TEWL, include humectants to attract water to the dehydrated epidermis, contain emollients to smooth the desquamating skin scale, and include physiological lipids to encourage regeneration of the lipid bilayer. This research examined the effect of a ceramide-based skincare regimen as compared to a non-ceramide-containing skincare regimen in participants with moderate facial acne who used adapalene (0.3%) and benzoyl peroxide (2.5%)(A/BPO) once daily in the evening. The goal was to determine the value of ceramides in mitigating acne medication-enhanced barrier dysfunction.
Carefully formulated and selected adjunctive skincare products can minimize additive barrier damage. A moisturizer effective in acne medication-induced irritation must provide occlusion to control TEWL, include humectants to attract water to the dehydrated epidermis, contain emollients to smooth the desquamating skin scale, and include physiological lipids to encourage regeneration of the lipid bilayer. This research examined the effect of a ceramide-based skincare regimen as compared to a non-ceramide-containing skincare regimen in participants with moderate facial acne who used adapalene (0.3%) and benzoyl peroxide (2.5%)(A/BPO) once daily in the evening. The goal was to determine the value of ceramides in mitigating acne medication-enhanced barrier dysfunction.
MATERIALS AND METHODS
Male and female participants aged 13 to 40 years with Fitzpatrick skin types I-VI and moderate facial acne (IGA = 3) with oily/combination skin types were enrolled in this single center double-blinded randomized study. Participants possessed a minimum of 15 inflammatory lesions and 15 non-inflammatory lesions. Participants signed an IRB-approved informed consent/assent (Allendale Institutional Review Board, Old Lyme, CT) prior to initiating any study activities and were assessed at baseline, week 1, week 4, week 8, and week 12. Participants were excluded if they had used any topical prescription or over-the-counter (OTC) acne medications in the past 2 weeks
