{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:39:30Z","timestamp":1789846770598,"version":"4.0.1"},"reference-count":90,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T00:00:00Z","timestamp":1679443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acne pathophysiology includes a complex interaction among inflammatory mediators, hyperseborrhea, alteration of keratinization and follicular colonization by <jats:italic>Propionibacterium acnes<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To describe the impact of the exposome on acne and how photoprotection can improve outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A narrative review of the literature was carried out; searches with Google Scholar and Pubmed from January 1992 to November 2022 were performed. The keywords used were \u201cacne,\u201d \u201csunscreens,\u201d \u201cphotoprotection,\u201d \u201ccosmetics,\u201d \u201ccosmeceuticals,\u201d \u201cpathogenesis,\u201d \u201cetiology,\u201d \u201cexposome,\u201d \u201csunlight,\u201d \u201cstress,\u201d \u201clack of sleep,\u201d \u201cdiet,\u201d \u201cpostinflammatory hyperpigmentation,\u201d \u201cpollution,\u201d \u201cexposome,\u201d \u201cultraviolet radiation,\u201d and \u201cvisible light.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Environmental factors such as solar radiation, air pollution, tobacco consumption, psychological stress, diverse microorganisms, nutrition, among others, can trigger or worsen acne. Solar radiation can temporarily improve lesions. However, it can induce proinflammatory and profibrotic responses, and produce post\u2010inflammatory hyperpigmentation and\/or post\u2010inflammatory erythema. While photoprotection is widely recommended to acne patients, only four relevant studies were found. Sunscreens can significantly improve symptomatology or enhance treatment and can prevent post\u2010inflammatory hyperpigmentation. Furthermore, they can provide camouflage and improve quality of life. Based on acne pathogenesis, optimal sunscreens should have emollient, antioxidant and sebum controlling properties.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The exposome and solar radiation can trigger or worsen acne. UV light can induce post\u2010inflammatory hyperpigmentation\/erythema, and can initiate flares. The use of specifically formulated sunscreens could enhance adherence to topical or systemic therapy, camouflage lesions (tinted sunscreens), decrease inflammation, and reduce the incidence of post\u2010inflammatory hyperpigmentation\/erythema.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.15726","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T12:35:29Z","timestamp":1679488529000},"page":"1919-1928","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Sun exposure, a relevant exposome factor in acne patients and how photoprotection can improve outcomes"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4481-5602","authenticated-orcid":false,"given":"J.","family":"Piquero\u2010Casals","sequence":"first","affiliation":[{"name":"Department of Dermatology Cl\u00ednica Dermatol\u00f3gica Multidisciplinar Dermik  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4704-6132","authenticated-orcid":false,"given":"D.","family":"Morgado\u2010Carrasco","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Cl\u00ednic de Barcelona, Universitat de Barcelona  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7435-7868","authenticated-orcid":false,"given":"E.","family":"Rozas\u2010Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital San Pablo  Coquimbo Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1450-697X","authenticated-orcid":false,"given":"J. F.","family":"Mir\u2010Bonaf\u00e9","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital Son Ll\u00e0tzer  Palma de Mallorca Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1925-5102","authenticated-orcid":false,"given":"C.","family":"Trull\u00e0s","sequence":"additional","affiliation":[{"name":"Innovation and Development, ISDIN  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9167-1077","authenticated-orcid":false,"given":"E.","family":"Jourdan","sequence":"additional","affiliation":[{"name":"Innovation and Development, ISDIN  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0952-740X","authenticated-orcid":false,"given":"J.","family":"Piquero\u2010Martin","sequence":"additional","affiliation":[{"name":"Department of Dermatology Instituto de Biomedicina, Universidad Central de Venezuela  Caracas Venezuela"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1646-2608","authenticated-orcid":false,"given":"C. C.","family":"Zouboulis","sequence":"additional","affiliation":[{"name":"Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg  Dessau Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8433-1517","authenticated-orcid":false,"given":"J.","family":"Krutmann","sequence":"additional","affiliation":[{"name":"IUF\u2010Leibniz Research Institute for Environmental Medicine  D\u00fcsseldorf Germany"},{"name":"Medical Faculty Heinrich\u2010Heine\u2010University  D\u00fcsseldorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/AHMT.S55832"},{"issue":"4","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/jdv.13182","article-title":"Pathophysiology and management of acne","volume":"29","author":"Gollnick HPM","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16614"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2020.00450"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-020-00531-1"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14820"},{"key":"e_1_2_11_8_1","first-page":"1","article-title":"Cosmetics for acne: indications and recommendations for an evidence\u2010based approach","volume":"150","author":"Dall'oglio F","year":"2015","journal-title":"G Ital Dermatol Venereol"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12895-015-0036-8"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.15519"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12920-021-00953-8"},{"key":"e_1_2_11_12_1","first-page":"380","article-title":"An acne survey from the World's largest annual gathering of twins","volume":"17","author":"Suggs A","year":"2018","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14385"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms3870"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms5020"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2004.03.011"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200363150-00005"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06794.x"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12298"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.4161\/derm.1.3.8473"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiochem.2011.06.984"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2010.03937.x"},{"key":"e_1_2_11_23_1","article-title":"Insulin resistance in polycystic ovarian syndrome","volume":"14","author":"Purwar A","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-1677"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00403-019-01908-x"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.13553"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm-21-5924"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2013.438"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2022.817899"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2007.05.013"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.isci.2021.102575"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.14467"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20180448"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757-4749-3-1"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.12885"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.14409"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms10071303"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2002.tb00313.x"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.12777"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.5021\/ad.2015.27.2.163"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.12330"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/phpp.12783"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2021.02.048"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S234231"},{"key":"e_1_2_11_45_1","first-page":"626","article-title":"Clinical relevance of skin barrier changes associated with the use of oral isotretinoin: the importance of barrier repair therapy in patient management","volume":"12","author":"Del Rosso JQ","year":"2013","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.1993.tb02242.x"},{"key":"e_1_2_11_47_1","first-page":"11","article-title":"Photobiology and phototherapeutics","volume":"19","author":"Kerr HA","year":"2003","journal-title":"Adv Dermatol"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.14899"},{"key":"e_1_2_11_49_1","first-page":"148","article-title":"Dioxin toxicity and chloracne in the Ukraine","volume":"4","author":"Sterling JB","year":"2005","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1159\/000366195"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11626-022-00658-x"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2001.04290.x"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14475"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abd.2019.02.005"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13835"},{"key":"e_1_2_11_56_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-021-02826-1"},{"key":"e_1_2_11_57_1","doi-asserted-by":"publisher","DOI":"10.1097\/JW9.0000000000000017"},{"key":"e_1_2_11_58_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40257-020-00542-y"},{"key":"e_1_2_11_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.15280"},{"key":"e_1_2_11_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2008.08959.x"},{"key":"e_1_2_11_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2022.05.066"},{"key":"e_1_2_11_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/srt.13048"},{"key":"e_1_2_11_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2016.10.007"},{"key":"e_1_2_11_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.15390"},{"key":"e_1_2_11_65_1","doi-asserted-by":"publisher","DOI":"10.5070\/D3268049797"},{"key":"e_1_2_11_66_1","first-page":"70","article-title":"Whey protein precipitating moderate to severe acne flares in 5 teenaged athletes","volume":"90","author":"Silverberg NB","year":"2012","journal-title":"Cutis"},{"key":"e_1_2_11_67_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/3644720"},{"key":"e_1_2_11_68_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1473-2165.2009.00455.x"},{"key":"e_1_2_11_69_1","doi-asserted-by":"publisher","DOI":"10.1080\/09546634.2018.1442552"},{"key":"e_1_2_11_70_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.14436"},{"key":"e_1_2_11_71_1","first-page":"SF3509935","article-title":"SUPPLEMENT INDIVIDUAL ARTICLE: optimizing skin Care in Acne Treatment\u2010Evaluation of a designated cleanser and moisturizer regimen with improvement in clinical outcomes","volume":"21","author":"Rosso J","year":"2022","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_11_72_1","first-page":"19","article-title":"The role of skin care as an integral component in the management of acne vulgaris: part 1: the importance of cleanser and moisturizer ingredients, design, and product selection","volume":"6","author":"Del Rosso JQ","year":"2013","journal-title":"J Clin Aesthet Dermatol"},{"key":"e_1_2_11_73_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.09.078"},{"key":"e_1_2_11_74_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14491"},{"key":"e_1_2_11_75_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13776"},{"key":"e_1_2_11_76_1","first-page":"5","article-title":"The role of skin Care in Optimizing Treatment of acne and rosacea","volume":"22","author":"Zip C","year":"2017","journal-title":"Skin Therapy Lett"},{"key":"e_1_2_11_77_1","first-page":"28","article-title":"The role of skin care as an integral component in the Management of Acne Vulgaris: part 2: tolerability and performance of a designated skin care regimen using a foam wash and moisturizer SPF 30 in patients with acne vulgaris undergoing active treatment","volume":"6","author":"Del Rosso JQ","year":"2013","journal-title":"J Clin Aesthet Dermatol"},{"key":"e_1_2_11_78_1","first-page":"289","article-title":"Tretinoin\u2010sunscreen mixture in the treatment of acne vulgaris","volume":"41","author":"Cullen SI","year":"1988","journal-title":"Cutis"},{"key":"e_1_2_11_79_1","first-page":"1104","article-title":"Adjunctive use of a facial moisturizer SPF 30 containing ceramide precursor improves tolerability of topical tretinoin 0.05%: a randomized, investigator\u2010blinded, split\u2010face study","volume":"11","author":"Schorr ES","year":"2012","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_11_80_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S355329"},{"key":"e_1_2_11_81_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16119"},{"key":"e_1_2_11_82_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S209728"},{"key":"e_1_2_11_83_1","doi-asserted-by":"publisher","DOI":"10.1111\/phpp.12707"},{"key":"e_1_2_11_84_1","doi-asserted-by":"publisher","DOI":"10.1111\/phpp.12211"},{"key":"e_1_2_11_85_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.04.079"},{"key":"e_1_2_11_86_1","doi-asserted-by":"publisher","DOI":"10.36849\/JDD.2020.5032"},{"key":"e_1_2_11_87_1","doi-asserted-by":"publisher","DOI":"10.1111\/phpp.12112"},{"key":"e_1_2_11_88_1","doi-asserted-by":"publisher","DOI":"10.36849\/JDD.6312"},{"key":"e_1_2_11_89_1","first-page":"19","article-title":"Racial differences in clinical characteristics, perceptions and behaviors, and psychosocial impact of adult female acne","volume":"7","author":"Callender VD","year":"2014","journal-title":"J Clin Aesthet Dermatol"},{"key":"e_1_2_11_90_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-022-00862-3"},{"key":"e_1_2_11_91_1","first-page":"173","article-title":"Emotional benefit of cosmetic camouflage in the treatment of facial skin conditions: personal experience and review","volume":"5","author":"Levy LL","year":"2012","journal-title":"Clin Cosmet Investig Dermatol"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.15726","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.15726","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.15726","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T18:31:59Z","timestamp":1700677919000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.15726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,22]]},"references-count":90,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1111\/jocd.15726"],"URL":"https:\/\/doi.org\/10.1111\/jocd.15726","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,22]]},"assertion":[{"value":"2023-01-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}