Expert consensus on holistic skin care routine: Focus on acne, rosacea, atopic dermatitis, and sensitive skin syndrome

Abstract

Background Treatment, cleansing, moisturizing, and photoprotection are four major components of holistic skin care for dermatological conditions. While treatment (T) is recognized as a key component in the management of dermatological conditions, there is a lack of practical guidance on the adjunctive role of cleansing, moisturizing, and photoprotection (“CMP”). Limited patient knowledge, confusion over product selection, and lack of guidance on how to choose and use CMP skin care products (in conjunction with pharmacological therapy) are the main barriers to establishing a holistic skin care routine for dermatological conditions. Aims This study aimed to review current clinical evidence, identify gaps, and provide practical guidance on conceptualization and implementation of CMP routine in the management of sensitive skin due to underlying acne, atopic dermatitis, or rosacea, including conditions with idiopathic causes referred to as idiopathic sensitive skin syndrome. Methods An expert panel comprising of 10 dermatologists from Australia, China, Hong Kong, Taiwan, India, Indonesia, Philippines, Singapore, South Korea, and Thailand convened to develop consensus statements on holistic skin care in acne, rosacea, atopic dermatitis, and idiopathic sensitive skin syndrome using the Delphi approach. Results Consensus was defined as ≥80% of panel rating statement as ≥8 or median rating of ≥8. The final statements were collated to develop consensus recommendations on holistic skin care. Conclusion A dermatologist‐guided holistic skin care routine is essential to improve patient confidence and reduce confusion over product selection. The consensus recommendations presented here highlight the importance of cleansing, moisturization, and photoprotection in holistic skin care and how it can be utilized as a communication tool for physicians and patients to achieve overall better patient compliance, satisfaction, and treatment outcomes.

Holistic care: Dietary recommendations for patients with acne and rosacea

“…We welcome the review and Delphi consensus of Goh and colleagues discussing considerations for optimizing skincare in patients with sensitive skin. 1 As part of holistic care of patients, we would encourage clinicians to also consider dietary recommendations when consulting patients. 2 For example, the NutriNet-Sante study is the largest cross-sectional study to date that interrogated adult acne and dietary behaviors through extensive serial questionnaires and yielded highly informative results.…”

“…Holistic care of patients is fundamental to the practice of medicine. We welcome the review and Delphi consensus of Goh and colleagues discussing considerations for optimizing skincare in patients with sensitive skin 1 . As part of holistic care of patients, we would encourage clinicians to also consider dietary recommendations when consulting patients 2 .…”

Five dimensions of cleansing: A holistic view on the facets and importance of skin cleansing

“…Beneficial effects are also described for integrated skin cleansing routines, exemplary for rosacea [24], acne [25], atopic dermatitis [26] or in the prevention of occupational hand dermatitis [27]. Against this background, skin cleansing should be an integral element as an adjunctive skin treatment, to alleviate symptoms, reduce severity, improve skin appearance, support treatment outcome and finally increase the patient's quality of life [21].…”

“…Additionally, skin cleansing was described in medical use as one of the ‘four major components of holistic skin care for dermatological conditions’ [21]. Targeted cleansing should be integrated into the dermatologist‐guided skincare routine as an adjunctive measure in skin disorders, and specific skin conditions along with other therapies [1].…”

An optimal method for quantifying the facial sebum level and characterizing facial sebum features

“…[6][7][8][9] Among these biophysical parameters, the skin sebum level was reported to be significantly associated with skin disorders such as acne, atopic dermatitis, psoriasis, and rosacea. [10][11][12][13] One study revealed that the skin sebum content is higher in dermatitis patients with a history of contact with sulfur mustard than in healthy people. 14 A comparative study demonstrated that increased sebum levels correlate with facial pore development in males.…”