{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:09:28Z","timestamp":1790809768436,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T00:00:00Z","timestamp":1692576000000},"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":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Acne is a common, complex, multifactorial inflammatory skin disease associated with epidermal barrier dysfunction. Beginning in childhood, acne affects many adolescents and adults. Acne is associated with lower self\u2010esteem, anxiety, and depression and may cause scars and pigmentary sequelae. The review explores the relationships between acne and the skin barrier function and discusses nuances in the prevention, treatment, and maintenance of acne and its impact on the skin barrier.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The advisors' previous publications addressed prescription and nonprescription pediatric acne treatment and skincare using cleansers, moisturizers, and a practical algorithm for treatment and maintenance, including skincare recommendations for pediatric acne patients and an algorithm for skin of color patients with acne.<\/jats:p><jats:p>Before the meeting, literature was culled on the relationship between the skin barrier and acne and current best practices in acne, addressing prescription and nonprescription acne products and skincare as monotherapy, adjunctive, and maintenance treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After discussing 13 draft statements, the advisors applied the selected literature and drew from their clinical knowledge and experience, and agreed on five statements. The follicular epithelial barrier is directly involved with changes that occur during both comedogenesis and in stages of inflammation, especially with follicular rupture compromising the barrier's integrity. In acne\u2010affected skin, sebaceous glands are larger, sebum excretion and filaggrin expression higher, and stratum corneum lipids are reduced.<\/jats:p><jats:p>Educating patients and clinicians about inflammation's central role in acne and measures to reduce inflammation is essential. Skin irritation and xerosis from acne and treatments lead to poor treatment adherence. A skincare regimen should be included in the acne prevention, treatment, and maintenance care regimen and should be ongoing. Maintenance treatment with topical agents and skincare using gentle ceramide\u2010containing cleansers and moisturizers is a recommended strategy after successfully controlling the disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Epidermal barrier dysfunction contributes to acne exacerbation. Using the appropriate treatment and skincare helps to minimize irritation and inflammation, enhance treatment adherence, and improve patient outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.15946","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T07:13:18Z","timestamp":1692688398000},"page":"2902-2909","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Insights into acne and the skin barrier: Optimizing treatment regimens with ceramide\u2010containing skincare"],"prefix":"10.1111","volume":"22","author":[{"given":"Lawrence A.","family":"Schachner","sequence":"first","affiliation":[{"name":"Division of Pediatric Dermatology, Department of Dermatology and Cutaneous Surgery, Department of Pediatrics Leonard M. Miller School of Medicine, University of Miami  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew F.","family":"Alexis","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5930-4162","authenticated-orcid":false,"given":"Anneke","family":"Andriessen","sequence":"additional","affiliation":[{"name":"Radboud UMC, Nijmegen and Andriessen Consultants  Malden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Berson","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical College  New York New York USA"},{"name":"New York\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5183-5433","authenticated-orcid":false,"given":"Michael","family":"Gold","sequence":"additional","affiliation":[{"name":"Gold Skin Care Center  Nashville Tennessee USA"},{"name":"Vanderbilt University School of Medicine and Nursing  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8950-439X","authenticated-orcid":false,"given":"David J.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Schweiger Dermatology Group  Hackensack New Jersey USA"},{"name":"Icahn School of Medicine at Mt. 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