Turkish consensus on dermocosmetics in acne: A modified Delphi study

Tatliparmak A., UZUNÇAKMAK T. K., Demircioglu D., Kesikoglu A. F., Baykaldi A., İLTER N.

TURKDERM-TURKISH ARCHIVES OF DERMATOLOGY AND VENEROLOGY, cilt.60, sa.2, ss.87-94, 2026 (ESCI, TRDizin)

Özet

Dermocosmetics are integral to acne management, not only as adjuncts to pharmacologic therapy but also in addressing post-acne complications and consistency with treatment. This modified Delphi-based consensus aimed to generate regionally contextualized, evidence-informed recommendations for dermocosmetic use in the major domains of acne care in T & uuml;rkiye. A two-round modified Delphi study was conducted among dermatology experts, evaluating 53 statements across five domains: dermocosmetic monotherapy, adjunctive use during pharmacologic treatment, management of post-acne erythema (PAE), management of post-inflammatory hyperpigmentation (PIH), and ingredient restrictions during systemic therapy. The expert panel included five dermatologists who examined and treated >= 100 patients with acne vulgaris monthly. Consensus was defined as an agreement of >= 80%. Consensus was achieved for all 53 statements in the study. In Domain 1, experts endorsed twice-daily cleansing with sodium lauryl sulfate-free, pH-balanced cleansers and recommended niacinamide, green tea extract, zinc, and bakuchiol for mild acne. Physical exfoliants and salicylic acid-based cleansers were discouraged. In Domain 2, moisturizers with ceramides/hyaluronic acid, antioxidants, panthenol/allantoin, and non-comedogenic sunscreen were strongly recommended during pharmacologic therapy. Probiotic/prebiotic formulations were recommended during systemic antibiotic use. In Domain 3, niacinamide, brimonidine, sun-protective agents, antioxidants, and vasoconstrictive agents were preferred for treating PAE. Domain 4 supported the use of niacinamide, vitamin C derivatives, tranexamic acid, and combinatory antioxidants for PIH, while arbutin, glabridin, and madecassoside were rejected due to insufficient evidence. Domain 5 emphasized avoiding salicylic acid, alpha hydroxy acid/beta hydroxy acid, physical scrubs, and concurrent topical retinoids or bakuchiol during systemic therapy. This expert consensus provides region-specific guidance on dermocosmetics across all phases of acne care. Recommendations emphasize barrier support, anti-inflammatory and pigment-modulating strategies, and ingredient safety during systemic therapy. This consensus positions dermocosmetics as a central component of acne care rather than a peripheral adjunct, offering clinicians a pragmatic roadmap for personalized, evidence-informed integration across the entire acne continuum.