guidelines and algorithms and clinical literature from Latin American countries on acne. Searches included clinical acne guidelines, algorithms, clinical studies, and review articles on acne prevention, treatment, and maintenance using OTC and skincare. For this purpose, searches on August 11 and 12, 2020, using PubMed and Google Scholar as a second source explored for English-language, Spanish and Portuguese literature using the following terms: "Latin American articles on Acne vulgaris, acne pathogenesis, acne therapy with OTC regimens, active cosmetics, acne guidelines, algorithms." Exclusion criteria included: Not addressing Latin American patients, no original data (unless a review article was deemed relevant), and not dealing with the clinical management of acne. Two clinicians manually reviewed the selected publications for additional resources. The literature searches yielded thirty-two papers. After excluding duplicates and papers deemed not relevant, five papers remained (Figure 2). Articles from other countries were used to provide information where needed and for the discussion. The results of the searches were summarized, presented, and discussed during the Webinar meeting.
Results of the Survey
OTC Monotherapy
Topical acne treatment can be given as monotherapy or combined with systemic therapy, depending on the acne type.7-11
The survey completed by the panel of dermatologists from Latin American countries asked which type of OTC acne monotherapy would be the physician's first, second, and third choice. The responders' first and second choices did not show a clear tendency to use a single acne product. Still, their third most prescribed product of choice was a serum of alpha hydroxy acid (AHA) and beta-hydroxy acid (BHA).
As a first choice, the respondents further recommended AHA and BHA containing serum, ceramides-containing foaming cleanser, a soap-free exfoliating cleanser, adapalene, and benzoyl peroxide (BPO) containing products. As a second and third choice, the dermatologists recommended BPO and lipohydroxy acid cream, a purifying gel cleanser, AHA containing gel, glycolic acid (GA) containing lotion or gel, and a spot treatment gel. Most of the formulations have a combination of AHA and GA. However, in the survey, AHA and GA were mentioned as two separate products.
BPO and lipo-hydroxy acid cream was recommended by the respondents for mild-to-moderate acne as, according to their experience, it is well-tolerated and has anti-inflammatory activity (Table 1).
The clinicians recommended OTC cleansing products mainly for younger patients at a starter level and for women with adult acne. The use of these OTC products is similar to practice described
