The panel agreed that while the number of studies on pH in acne is low, a growing body of evidence suggests the use of skin care augments skin barrier function, thereby reducing irritation and increasing adherence to treatment, thus improving outcomes.
Statement 6: Education of patients with acne on appropriate cleansing and moisturizing can improve skin barrier function, treatment adherence, and results.
Educating patients on inflammatory events and skin barrier dysfunction involved in acne lesion development is essential to understand the measures that are needed to improve skin condition.8,9 Contrary to the popular belief that drastic cleansing measures are needed to reduce sebum production and to combat inflammatory lesions, it is important to educate patients on how skin irritation and inflammation can be reduced.9,25 Once patients with acne-affected skin understand how they can manage the dryness and irritation that result from treatment and from the condition itself, they may be motivated to use cleansers and moisturizers close to physiologic skin surface pH (Figure 2).22,25
Conclusive evidence on the role of skin pH in acne as well as on best measures to maintain an acidicphysiologic skin surface pH is lacking. Therefore, consensus statements and recommendations were based on the best available clinical evidence and reflecting the knowledge and practical experience of the expert panel.
More evidence on the role of skin pH in acne as well as on measures to maintain an acidic skin surface pH is needed. As an adjunct to treatment for acne, pH-balanced and ceramidecontaining cleansers and moisturizers may help in maintaining skin barrier function.
- Bhate K, Williams HC. Epidemiology of acne vulgaris. Br J Dermatol. 2013;168(3):474-85.
- Hay RJ, Johns NE, Williams HC, Bolliger IW, Dellavalle RP, Margolis DJ, et al. The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions. J Invest Dermatol. 2014;134(6):1527-34.
- Halvorsen JA, Stern RS, Dalgard F, Thoresen M, Bjertness E, Lien L. Suicidal ideation, mental health problems, and social impairment are increased in adolescents with acne: a population-based study. J Invest Dermatol. 2011;131(2):363-70.
- Sundström A, Alfredsson L, Sjölin-Forsberg G, Gerdén B, Bergman U, Jokinen J. Association of suicide attempts with acne and treatment with isotretinoin: retrospective Swedish cohort study. BMJ. 2010;341:c5812.
- Dreno B, Pecastaings S, Corvec S, Veraldi S, Khammari A, Roques C. Cutibacterium acnes (Propionibacterium acnes) and acne vulgaris: a brief look at the latest updates. J Eur Acad Dermatol Venereol. 2018;32 Suppl 2:5-14.
- Melnik BC. Linking diet to acne metabolomics, inflammation, and comedogenesis: an update. Clin Cosmet Investig Dermatol. 2015;8:371-88.
- Boer M, Duchnik E, Maleszka R, Marchlewicz M. Structural and biophysical characteristics of human skin in maintaining proper epidermal barrier function. Postepy Dermatol Alergol. 2016;33(1):1-5.
- Thiboutot D, Del Rosso JQ. Acne vulgaris and the epidermal barrier: Is acne vulgaris associated with inherent epidermal abnormalities that cause impairment of barrier functions? Do any topical acne therapies alter the structural and/or functional integrity of the epidermal barrier? J Cosmet Dermatol. 2013;6(2):18-24.
- Lovaszi M, Szegedi A, Zouboulis CC, Torocsik D. Sebaceous-immunobiology is orchestrated by sebum lipids. Dermato-endocrinology. 2017;9(1):e1375636.
- Christensen GJ, Bruggemann H. Bacterial skin commensals and their role as host guardians. Benef Microbes. 2014;5(2):201-15.
- Kwon HH, Suh DH. Recent progress in the research about Propionibacterium acnes strain diversity and acne: pathogen or bystander? Int J Dermatol. 2016;55(11):1196-204.
- Elsaie ML. Hormonal treatment of acne vulgaris: an update. Clin Cosmet Investig Dermatol. 2016;9:241-8.