recommending OTC products also when encouraging the use of a photoprotective product that is still suitable for acne-prone skin (ie, non-greasy formulation, thin application). When asked what advisors looked for in an OTC adjunct to acne therapy, responses included being physiological-based, hypoallergenic, affordable, and able to provide long-lasting moisturization. To reduce unwanted side effects of prescription acne treatments (eg, drying, stinging), the panel recommended that moisturizers be applied prior to other topical agents.
Product recommendations varied depending on the primary intended use of the products (ie, as a stand-alone therapy; as an adjunct to treatment; for maintenance of treatment results). For acne monotherapy, OTC products reported to be used by advisors included SkinCeuticals, Effaclar Duo+, Benzac Wash, Avène Diacneal, and Differin (Table 1). Adjunctive and maintenance OTC products included La Roche Posay, Effaclar Duo Plus, Cetaphil, CeraVe Foaming Cleanser, and Neutrogena cleanser (Table 2 and Table 3).
For cleansers, advisors stressed the caveat that Asian skin tends to be more sensitive than other phototypes. Thus, irritants commonly included in cleansers for acne-prone skin (eg, salicylic acid) may lead to greater severities of irritation in these patients. Concentrations of these ingredients may need to be lower in products aimed at targeting the Asian market, or less irritating ingredients should be considered. For example, advisors proposed using 10–15% azelaic acid instead of 2% salicylic acid in a product targeting pigmentation. It was also thought useful to add ingredients capable of counteracting the transient irritation caused by azelaic acid. Other ingredients found suitable by the advisors were nicotinic acid and/or tranexamic acid. Advisors concluded that there is a current unmet need for an economical product indicated for face, back, and chest acne and that the ideal product to be used in an acne regimen would include lipid-free cleansers, synthetic detergents (syndets), astringents, exfoliants, or mild abrasives. Cleansing liquids were preferred over bars. Finally, the expert panel concluded that, while the choice of the cleanser should be suited to the patient's skin profile, all acne patients can benefit from a cleansing regimen and should therefore be educated on the proper selection and use of cleansers, as they have been found to increase treatment compliance and reduce lesions.20,21
DISCUSSION
Supporting Literature
A list of literature regarding the use of OTC products in acneprone skin is displayed in Table 4. A recent large-scale review of a national patient database revealed that acne monotherapies are typically prescribed without co-prescribing topical nonantibiotic agents.12 However, OTC products are believed to target various etiopathogenic factors of acne (eg, antibacterial,
A list of literature regarding the use of OTC products in acneprone skin is displayed in Table 4. A recent large-scale review of a national patient database revealed that acne monotherapies are typically prescribed without co-prescribing topical nonantibiotic agents.12 However, OTC products are believed to target various etiopathogenic factors of acne (eg, antibacterial,
