Introduction: 1. .

Acne is an extremely common condition whose management varies considerably according to the severity of the lesions, from the simple purchase of mass-market cosmetics for oily skin to the prescription of isotretinion by a dermatologist. 2. Pharmacists play a major role as consultants, as many customers ask about acne care and a broad array of products is available in pharmacies. 3. Thus, the market for skin products is considerable. Dermatologists, patients , dermo-cosmetics How dermatologists feel about skin care products? 1. As a preliminary, we need to determine whether a true cosmetic dermatology approach to acne exists and if it does, whether dermatologists have integrated it within their everyday clinical practice. 2. The questions are reminders that the cosmetic dermatology approach to acne is virtually absent from official academic communications about the disease. 3. In many countries role for dermatologists is confined to prescribing drugs and performing procedures. 4. Advice about cosmetics is provided in pharmacies and beauty centers independently from the physician visit 5. Cosmetics improve the chances of successful treatment 6. Demo-cosmetics should ensure gentle cleaning while preserving the hydro-lipid film and correcting the skin dryness and irritation associated with the use of topical acne medications. 7. In addition, patients with acne should use make-up products shown in tests to be non-comedongenic What the patients want? 1. Skin that looks less shiny and greasy, elimination of the blackheads, and a means of concealing the pimples Changes over time in skin care products for acne 2. Three main periods can be distinguished. 3. 30 years ago, cosmetic products were yet not available and cosmetics were ill suited to acne care. 4. Thus, the skin cleansers were detergents and creams were oil-based; many products contained sulfur, which is potentially comedogenic; and some of the topic products caused skin irritation. 5. The second period witnessed the development of cosmetic products that were more specifically designed for acne care. Cleansers designed to avoid rebound sebum secretion became available, as well as the creams to control shininess and products to accompany the use of irritant treatments such as oral isotretinion, which was introduced in the mid1980’s. 6. Finally in the last 15 years, numerous skin care products claimed to exert direct benefits on acne lesions were introduced. 7. These ‘active’ cosmetics target excess sebum production, inflammation, comedones, keratinocyte dysregulation bacteria and other factors involved in acne. Skin cleansers for acne patients

combat irritation. Hence.7) 5. gentle and well tolerated. which combine several gentle synthetic tensioactive agents and preserve the normal skin pH (4. 2. Many active agents are found in daily skin care. Early foundations for acne were thick products that covered the lesions. oral isotretinion therapy induces side effects such as cheilitis. whereas others are designed to be used daily. Adjunctive cosmetics for occasional use 1. Acne is often perceived negatively as a sign of faulty hygiene and inadequate attention to personal care. Soaps should be replaced with detergent free bars or gels (syndets). Patients should receive advice about appropriate hygiene. which includes cleansing the skin once or twice a day with products that are nondetergent. 5. 4. Make up and sunscreens 1. lotions and foams for acne patients contain gentle synthetic detergents. The dermatologist should correct this misperception by explaining that the disease is unrelated to poor hygiene. Many of them contain active agents that exert antibacterial effects. Cleansing gels. they also occluded the skin . tolerance and acceptability of acne care products. Women with acne are usually desirous to conceal the lesions. a. effectiveness. 3. 2. regulate sebum production or regulate keratinocytes. Exfoliation is achieved by gels that contain microbeads or microsphere or abrasive sponges and brushes b. some are intended for occasional use as adjuncts to other treatments. creams. thus diminishing shine c. Products for daily skin care include creams that treat the acne lesions. Dermo-cosmetics for acne patients 1. thereby increasing treatment adherence. Facial masks containing a clay or kaolin base temporarily absorb surface lipids. Acne patches are designed to be left overnight on the inflammatory lesions. and/or contain specific agents.1. xerosis and increased sensitivity to sunlight. And some combinations are really useful for the treatment of acne. 4. Exfoliating agents : remove the outer cells of stratum corneum and facilitate comedo extraction . 3. Among cosmetics for acne care. moisturize the skin. patients on isotretinion therapy must use appropriate cosmetic dermatology products to maintain comfort and enhance adherence. However. Daily skin care 2. . A number of skin care products are intended for use as adjuncts to other treatments. provide a soothing effect. These products can be used alone in patients with mild acne or in combination with systemic or topical treatment in patients with moderate –to-severe acne therapy . They contain salicylic acid and antibacterial agents that diffuse into the lesions. For instance. 3. increasing the rise of comedo formation and folliculitis. Substantial advances in galenic formulations have improved the penetration.

As a result. as it implies a therapeutic component with effects that inevitable extend beyond the skin surface. these products are given the status of quasi-drugs. misunderstood legislation. Cosmetic definition does not restrict its use depending on type of skin 3. Protecting from sunlight is a challenging goal in adolescents. Therefore. they are reluctant to accept the device about sunlight protection given by dermatologists. Cosmetics and acne: borderline products. Acne management by dermatologist is an excellent example of the need to combine medication and dermo-cosmetics. Given this ambiguity. progress in galenic formulations enabled the development of non-oily concealers shown in tests to be non-comedogenic. 1. 5. using cosmetics on an abnormal skin is legitimate. 5. 4. 2. some countries (e. 7. Active cosmetology remains an ambiguous concept. In japan. Subsequently. Table 1. 6. 6.4. Australia and the US) have defined a category of products between cosmetics and pharmaceuticals known as cosmeceuticals. Negotiation is more likely to be successful than a directive approach and is helped by availability of filters and screens that a designed for patients with acne. who usually experience a dramatic improvement in their acne lesions during the summer.g. example of active agents contained in cosmetics with label claims of beneficial health effects Decreased Decrease Regulate Combat Regulate irritation inflammation keratinovytes bacteria sebum Thermal Zinc and Retinaldehyd Zinc and Zinc and spring water derivatioves e derivatives derivatives Hydroxyl Bitamin b6 Gingko biloba acids Retinaldehyd Cucurbia pepo Niacinamide Linoleic acid e extract Glycyrrhetini Lipacid c8g c acid Gingko biloba Triclosan Xylitol + fructoAlphaTrl2 regulator Tea tree oil oligosacchride bisabolol s + mannitol + Glycyrrhetini Glycadone rhamnose Allantoin c acid Licochalcone Myrtacine Sabal serrulata hammamelis A Laminaria CTAB ochroleuca Epilobe extract .

Examples of terms allowed for marketing various classes of products Indications Medications Cosmetics with Cosmetics without the pp visa the pp visa Treatment of a diseases Acne treatment Anti-acne Secreses sebum production ‘health care claims’ Care of oily skin Eliminates excesll care of acne-prone sebum skin problem skin in young people adjunct to acne treatments decreases sebum production Shine control .