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Indian Journal of Dermatology, Venereology and Leprology, Vol. 75, No. 7, , 2009, pp. 55-56 Acne in India: Guidelines for management - IAA Consensus Document Cosmetics and skin care in acne Raj Kubba, AK Bajaj, DM Thappa, Rajeev Sharma, Maya Vedamurthy, Sandipan Dhar, S Criton, Rui Fernandez, AJ Kanwar, Uday Khopkar, Malavika Kohli, VP Kuriyipe, Koushik Lahiri, Nina Madnani, Deepak Parikh, Sudhir Pujara, KK Rajababu, S Sacchidanand, VK Sharma, Jayakar Thomas - members Indian Acne Alliance Correspondence Address: Dr. Raj Kubba, Consultant Dermatologist, Kubba Clinic, 10, Aradhana Enclave, Ring Road, New Delhi - 110066, India. rajkubba@hotmail.com Code Number: dv09249 A cosmetic is defined as an "article intended to be rubbed, poured, sprinkled, or sprayed on the human body for the purpose of cleaning, beautifying, promoting attractiveness, or altering the appearance without affecting the body′s structure or function." [1] Appropriate skin care contributes to successful management of acne. Skin care needs to be rational, flexible, and adaptive. The objective is to keep the skin and hair (scalp) clean, to control oiliness and prevent excessive dryness, to understand the changing needs of the skin on a daily basis brought about by variations in environmental conditions, physical activities, and the effects of topical and systemic treatments, and to compensate for such changes so as to maintain the skin in a near-ideal state. This is possible to achieve by balancing cleansing, moisturizing, and judicious use of supplemental skin care products. Cleansers: The purpose of cleansing is to remove dirt, sebum, and sweat that could stick on to an oily skin. Soaps are not recommended as they dry up the skin which is already dry and irritated with topical medications such as retinoids and BPO. Frequent washing to reduce oiliness is counterproductive as it leads to rebound oiliness through irritation of the sebaceous gland. Steaming, scrubbing, and the use of exfoliants make acne worse. Soap-free cleansers with pH of 5-7 are the best. Salicylic-acid-containing cleansers as gels and foams are helpful in the early stages of treatment. Lathering antiseptics, lather-producing gels or creams, should be discouraged as they can irritate acne-treated skin. Cleansing milk is better for make-up removal versus toners and astringents. Shaving: Daily shaving can irritate the skin. An electric shaver may be better option than hand-held razor. [2] A shaving gel or cream is better than shaving foam. A moisturizing lotion is better than conventional after-shave lotion. Hair oils: Liberal use of hair oils or oil massages is to be discouraged as this could contribute to pomade acne. Frequent shampooing is advised to keep scalp free of seborrhea. Adjuvants cosmetics: Cosmetics with fragrances and photosensitizers should be avoided. Water-based foundation is safe to use. Moisturizers: Most topical antiacne treatments lead to dryness or desquamation of skin. Appropriate use of oil-free moisturizers should be permitted or even encouraged. The objective is to correct dryness to be comfortable in feeling and appearance without causing oiliness. Sunscreen products: Some acne treatments have the potential to cause photosensitivity. Even otherwise, a parallel objective of treatment is to enhance the skin. Sunprotection and tan prevention is encouraged. This requires identifying a suitable sunscreen product which is then incorporated in the daily routine. Most sunscreens are too oily for acne patients and tend to aggravate it. Lately, some sunscreen gels and oil-free lotions have become available that are suitable for acne patients. Masks: These are the products that contain substances like clay, kaolin, or talc, which can absorb sebum and make the skin temporarily dry. [3] Exfoliators: These are the products which contain cornedolytics like salicylic acid, glycolic acid, and resorcinol. They are available as cleansers, washes, leave-on-gels, and scrubs. Exfoliators speed the natural renewal of skin cells and help in the treatment of acne by alleviating comedones. [4] Foundations: They are thick and occlusive and can lead to cosmetic acne. Hence, oil-free foundations are better. Oils in foundations are substituted by silicone derivatives like cyclometissue or dimethicone. In conclusion, dermatologists should acquire sound knowledge and familiarity with skin care products that need to be recommended or condemned as part of acne management. Skin care products labeled as "noncomedogenic" or "tested for comedogenicity" help make the job easier. Incorporating cosmetics in acne treatment regimens supports the concept of the dermatologist as the skin care expert. References
Copyright 2009 - Indian Journal of Dermatology, Venereology and Leprology |
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