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Effects of Acne Treatments on Barrier Damage and Skin Hydration: Modalities to Effectively Manage Them

Dr. Vivek M 316 Views

Effective acne management depends not only on disease control but also on treatment tolerability. Retinoids, benzoyl peroxide (BPO), acids, keratolytics, and isotretinoin target comedogenesis, microbial load, and inflammation but may cause dryness, peeling, tightness, burning, stinging, erythema, scaling, and increased transepidermal water loss (TEWL).[1] These barrier-stress signals can reduce adherence and compromise treatment outcomes. Hydration depends on corneocyte integrity, natural moisturizing factors, lipid lamellae, and controlled water loss; therefore, oily skin may remain dehydrated and sensitive. A practical approach is to start low, go slow, simplify, and review, using gentle cleansing, moisturizer, and photoprotection while avoiding unnecessary active stacking. Humectants such as hyaluronic acid (HA) provide water-binding, lightweight hydration and complement ceramides and film-forming ingredients.[2] Supportive skincare should be introduced early to preserve comfort and adherence without replacing active acne therapy. The clinical goal is treat acne effectively while protecting the skin barrier so patients can remain on therapy.

Reference(s):

1. Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024;90(5):1006.e1-1006.e30. doi:10.1016/j.jaad.2023.12.017 https://pubmed.ncbi.nlm.nih.gov/38300170/

2. Bravo B, Correia P, Gonçalves Junior JE, Sant'Anna B, Kerob D. Benefits of topical hyaluronic acid for skin quality and signs of skin aging: From literature review to clinical evidence. Dermatol Ther. 2022;35(12):e15903. doi:10.1111/dth.15903 https://pmc.ncbi.nlm.nih.gov/articles/PMC10078143/