Date of Award

Spring 2020

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Zachary Weik, PA-C

Second Advisor

Kevin Basile, MD

Abstract

Introduction: Acne is a common skin disorder with multifactorial causes that can persist beyond adolescence or appear for the first time in adulthood. Treatments of varying potency exist, ranging from over-the-counter face washes and creams to prescription topical and oral treatments. Current treatment guidelines target sebum production, exfoliation of excess skin cells, and the bacteria Propionibacterium acnes. Research as early as 1995 suggests dysfunctions of the skin barrier, such as abnormal ceramide levels and increased water loss, play a role in the pathophysiology of acne and are not addressed by current treatments. This review analyzes the role of moisturizing products (I) in improving acne (O) in adult patients (P) compared to standard non-moisturizing treatments (C).

Methods: A literature search was conducted in PubMed, Journals@Ovid and Google Scholar in the fall of 2018 using the terms “skin barrier”, “acne”, and “adult” joined with the MeSH term “AND.” A total of eight articles including randomized controlled trials, case-control, and cohort studies were analyzed. The five most relevant articles are reviewed in this paper.

Results: When moisturizers were applied in conjunction with standard acne treatments, participants showed visible improvement in acne appearance as well as improved treatment tolerability and reduced transepidermal water loss (an indicator of skin barrier health). Visible improvement was also seen when moisturizers were used as part of a dermatologist designed skincare routine or in a novel treatment formulation.

Discussion: Moisturizers reduce the appearance of acne and improve skin barrier health markers such as transepidermal water loss and ceramide levels when used as part of an anti-acne regimen or in conjunction with standard treatments. However, moisturizers are consumer products and most studies are funded by skincare or pharmaceutical companies with an interest in the product’s success, leaving the research open to bias.

Conclusion: The connection between skin barrier health and acne is unclear, however, moisturizers that improve skin barrier health markers may be beneficial when used in conjunction with standard acne treatment regimens. Moisturizers are a safe, readily available adjuvant treatment that improve standard acne treatment tolerability and help improve the appearance of acne-affected skin.

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Does enhancing epidermal barrier function with moisturizing topical products improve acne vulgaris in adult patients compared to non-moisturizing products or non-intervention?

Introduction: Acne is a common skin disorder with multifactorial causes that can persist beyond adolescence or appear for the first time in adulthood. Treatments of varying potency exist, ranging from over-the-counter face washes and creams to prescription topical and oral treatments. Current treatment guidelines target sebum production, exfoliation of excess skin cells, and the bacteria Propionibacterium acnes. Research as early as 1995 suggests dysfunctions of the skin barrier, such as abnormal ceramide levels and increased water loss, play a role in the pathophysiology of acne and are not addressed by current treatments. This review analyzes the role of moisturizing products (I) in improving acne (O) in adult patients (P) compared to standard non-moisturizing treatments (C).

Methods: A literature search was conducted in PubMed, Journals@Ovid and Google Scholar in the fall of 2018 using the terms “skin barrier”, “acne”, and “adult” joined with the MeSH term “AND.” A total of eight articles including randomized controlled trials, case-control, and cohort studies were analyzed. The five most relevant articles are reviewed in this paper.

Results: When moisturizers were applied in conjunction with standard acne treatments, participants showed visible improvement in acne appearance as well as improved treatment tolerability and reduced transepidermal water loss (an indicator of skin barrier health). Visible improvement was also seen when moisturizers were used as part of a dermatologist designed skincare routine or in a novel treatment formulation.

Discussion: Moisturizers reduce the appearance of acne and improve skin barrier health markers such as transepidermal water loss and ceramide levels when used as part of an anti-acne regimen or in conjunction with standard treatments. However, moisturizers are consumer products and most studies are funded by skincare or pharmaceutical companies with an interest in the product’s success, leaving the research open to bias.

Conclusion: The connection between skin barrier health and acne is unclear, however, moisturizers that improve skin barrier health markers may be beneficial when used in conjunction with standard acne treatment regimens. Moisturizers are a safe, readily available adjuvant treatment that improve standard acne treatment tolerability and help improve the appearance of acne-affected skin.

 
 

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