Importance of dermocosmetics in the management of acne

Acne is the major dermatological disease as per the number of patients affected. Adolescents are suffering acne, but also more and more post-adolescent women. Acne is a multifactorial disease involving four main pathogenic pathways: increased and altered sebum production; inflammation; changes in the keratinization process resulting in abnormal keratinization; and follicular colonization by C. acnes. Until now, the treatment is mostly based on pharmacological substances, which often present side effects and for this reason offer bad compliance from the patients. Nevertheless, a number of dermocosmetics contain active ingredients, most of them vegetal, capable of focusing all four pathogenic pathways and obtaining satisfactory results. The most relevant seboregulator substances are butyl avocadate, but also epigallocatechin-3-gallate. In the category of antimicrobial agents, the most commonly used are tea tree oil, decanediol and Quassia amara extract. Among anti-inflammatory substances, we can mention Salix alba and Gingko biloba extracts, but also zinc, panthenol and superoxide dismutase. As per anti-keratolytic agents, alpha-hydroxy acids are commonly used, as well as salicylic acid, a beta-hydroxy acid. Nicotinamide is an ingredient of choice due to its multiple positive effects on the pathogenesis of acne. Early management of acne is crucial, in order to limit its symptoms and severity, but also avoid sequelae as serious as prolonged erythema or acne scars. This early management must be based on a holistic approach of acne, not necessarily including pharmacological treatment, but dermocosmetics, in particular in case of mild acne or as maintenance treatment. In this holistic approach, emphasis must be given on cleansing and moisturizing of the skin, and sun protection.