Choosing the Right Partner: Complementing Prescription Acne Medication With Over-the-Counter Cleansers and Moisturizers.

BACKGROUND: Acne is the most common dermatological disorder. An impaired barrier function in acne vulgaris has been reported, as well as decreased amounts of epidermal ceramides. Also, many of the systemic and topical medications prescribed for the treatment of acne exacerbate these skin barrier disruptions and can lead to irritation and dry skin conditions. AIM: The review explored the importance of maximizing adjunctive skincare, such as over-the-counter products for managing acne and avoiding adverse effects. METHODS: A literature review was conducted and included clinical acne guidelines, clinical studies, and review articles on acne prevention, treatment, and maintenance. Searches were made in PubMed and Google Scholar for English-language literature published between Jan 1, 2010, and Apr 1, 2020. Two clinicians manually reviewed selected publications. RESULTS: Seventy-four articles were included in the analyses. A variety of specialized cleansers and moisturizers are available as suitable adjunctive therapies for acne-prone skin. Lipid-free cleansers were found to be the most appropriate type of cleanser for acne-prone skin as they were associated with a low risk of skin irritation, and a near-physiological stratum corneum pH. Moisturizers typically included ingredients such as humectants, emollients, oil absorbers, and those with anti-inflammatory and/or barrier replenishing properties. Given the various adjunctive products available, decision frameworks were created for clinicians to use when selecting over-the-counter cleansers and moisturizers for acne-prone patients. CONCLUSION: Informing clinicians about skin barrier dysfunction in acne and the benefits of adjunctive skincare may help them to choose the right product(s) to complement prescription therapy. J Drugs Dermatol. 2020;19(11): doi:10.36849/JDD.2020.5536.

Assessment of a wound cleansing solution in the treatment of problem wounds.

 Chronic wounds will heal in most cases if provided an optimal local wound environment and therapy that addresses underlying disease. The quality of topical wound management will influence the speed of the wound healing process. The value of cleansing chronic wounds is considered a basic principle in modern wound management. Several methods are available for wound cleansing and debridement. Currently, there has been focus on measures of wound cleansing whereby debris and exudate are gently and continuously removed to prepare the wound bed for wound closure. For this purpose, physiological solutions or specific disinfectants may be used. This retrospective analysis of existing data was performed looking at the clinical efficacy and cost-effectiveness of using a wound antiseptic to treat problem wounds. Wound cleansing upon dressing changes using a polyhexanide containing solution (Prontosan®, B Braun, Melsungen AG, Germany) in venous leg ulcers was compared to cleansing with either Ringer's solution or saline. The wounds of the patients treated with polyhexanide solution healed faster and in more cases (97% versus 89%). The Kaplan-Meier mean estimate (and associated standard error [SE]) demonstrated a statistically significant difference between treatment groups (P < 0.0001) in time to healing. The Kaplan-Meier mean time to healing for the study group (SG) was 3.31 months (SE = 0.17) compared to 4.42 months (SE = 0.19) for the control group ([CG], saline/Ringer's solution). .