in Europe and by an international panel of dermatologists.11,12 The survey respondents used AHA and BHA containing serums for their efficacy and ease of use by teenagers and adult women. Respondents recommended topical OTC strength retinoids for full-face application for mostly young patients with noninflammatory acne. The recommended treatment is similar to the recommendation given for mild to moderate acne in Latin American countries, Spain, and Portugal.7 The algorithm further suggests the treatment is to be used in combination with skin care, such as gentle cleansers and moisturizers.7
When asked, panel members answered that the ceramidescontaining cleansers were used for those that did not have oily skin and might be sensitive to BPO containing cleansers. Washes, scrubs, and topical medications, such as retinoids, antibiotics, and BPO, may alter the skin barrier, causing irritation and dry skin.12-14 Especially in individuals with skin prone to irritation, these products possibly reduce adherence to treatment and therapeutic outcomes.12-14
OTC Products for Adjunctive Treatment
As their first choice adjunctive treatment, the respondents recommended OTC products, such as ceramides-containing cleansers or thermal water. They further advised the adjunctive use of creams or serums with BPO and AHA or adapalene and BPO or niacinamide. As a second and third choice, various cleansing agents were recommended, such as those containing thermal water or micellar technology. Other recommended products included HA containing serum, SA containing lotion, exfoliating moisturizer, and sunscreen. Most of the products were used on the face for moderate-to-severe acne in combination with prescription products. The OTC products were applied once or twice a day, morning or evening on the full face or spot treatment, and for preparation of the skin for other products. As a rationale for their choice, the dermatologists answered that these OTC products are cosmetically elegant (texture), non-irritating well-tolerated, anti-inflammatory, repair the skin barrier, post-inflammatory hyperchromia, follicular occlusion, sebum-controlling purposes (Table 2).
OTC Maintenance Treatment
As their first OTC choices for maintenance treatment, the respondents mentioned a cleansing gel, creams or serums with BPO and AHA and BHA or an OTC strength topical retinoid.
The respondents recommended a ceramide containing cleanser, SA containing lotion, an AHA-containing product, and sunscreen as a second and third choice.
The respondents noted that most products were used for the face twice daily.
When asked why these OTC products were used, the dermatologists answered that the products have attractive features, such as not oily, a suitable texture, and non-irritating. The respondents further noted that in their experience, the OTC products help to prevent acne flares, are anti-inflammatory, anti-follicular occlusion, control oily skin, and minimize scars (Table 3).
