TOPLINE:

A panel of dermatologists reached a consensus on 23 topical ingredients that they considered useful for seven common skin concerns, with retinoids recommended for five of those conditions.

METHODOLOGY:

• A literature review (1990-2020) identified 318 discrete cosmetic ingredients, which were then evaluated by 17 expert dermatologists who were either program directors of American Society for Dermatologic Surgery–accredited Cosmetic Dermatologic Surgery Fellowship programs or recognized experts in cosmetic dermatology.
• A panel of 62 dermatologists across 43 institutions completed two rounds of Delphi consensus surveys from September 2023 to September 2024.
• Skin concerns were fine lines and wrinkles, acne, redness, dark spots, large pores, dry skin, and oily skin.
• An ingredient was included on the final recommended list for a concern when consensus was achieved when ≥ 70% of panelists rated an ingredient between 7 and 9 and ≤ 15% rated it between 1 and 3 on a 9-point Likert scale during the second round.

TAKEAWAY:

• Consensus was achieved on 23 key ingredients for treating seven skin concerns: Ammonium lactate (dry skin), azelaic acid (acne, dark spots) benzoyl peroxide (acne, oily skin), brimonidine (redness), ceramides (dry skin), chemical sunscreen (fine lines and wrinkles), clindamycin (acne), glycolic acid (acne, dark spots), green-tinted products (redness), hyaluronic acid (dry skin), hydroquinone (dark spots), ivermectin (redness), kojic acid (dark spots), metronidazole (redness), mineral sunscreen (fine lines and wrinkles, redness), niacinamide (redness, dark spots), petrolatum (dry skin), retinoids (fine lines and wrinkles, acne, dark spots, large pores, oily skin), salicylic acid (acne, oily skin), sulfacetamide-sulfur (redness), tranexamic acid (dark spots), urea (dry skin), and vitamin C (fine lines and wrinkles, dark spots).
• Retinoids received the highest consensus rates, with 96.8% of experts recommending them for fine lines and wrinkles, acne, and dark spots, while 93.6% endorsed them for large pores and oily skin.
• Mineral sunscreen achieved 96.8% consensus for fine lines and wrinkles and 95.2% for redness, while hydroquinone received 98.4% consensus for dark spots.
• Overall, 44% of consensus ingredients were supported by level 1b evidence and 47% by level 2b evidence, with 5.88% lacking published evidence for their listed indications.

IN PRACTICE:

“Given the proliferation of novel and reformulated cosmetic ingredients and the relentless advertising and marketing campaigns touting the benefits of the products that contain them, selecting among such products and deciding which ingredients to prioritize can be a bewildering task even for well-informed patients and their doctors,” the authors wrote. “Patients and their dermatologists can use this information as a starting point for building a skincare routine,” they added.

SOURCE:

The study was led by Gabriella V. Alvarez, MD, The University of Texas MD Anderson Cancer Center, Houston, and was published online in the Journal of the American Academy of Dermatology.

LIMITATIONS:

The study relied on an expert panel composed of practicing cosmetic dermatologists who were also professors, researchers, and teachers of cosmetic dermatology. Additionally, all results were based on expert opinion rather than systematic review or meta-analysis.

DISCLOSURES:

The authors reported that no funding was received for this study. Some authors reported receiving consulting, travel, and advisory fees; serving as investigator; and owning stocks in various cosmetic and pharmaceutical companies, including Revision, Sente, and L’Oréal. One author reported being the founder of DAR Companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.