Cosmeceuticals in acne vulgaris: from mechanism of action to clinical application

The use of cosmeceuticals in acne vulgaris is becoming increasingly prevalent with many over-the-counter formulations becoming part of patients' routine skincare. Cosmeceuticals are often used successfully as an adjunctive therapy to reduce the side effects of traditional prescriptions and improve compliance. This is a review to support the use of cosmeceuticals in acne, including retinol, retinaldehyde, benzoyl peroxide (BPO), azelaic acid, beta hydroxy acids, alpha hydroxy acids, niacinamide, zinc, tea tree oil and green tea. There is most evidence, in human clinical trials, to support the use of topical retinol, BPO and azelaic acid. Further research with large-scale robust human clinical trials are required to go beyond in vitro studies. Most research has focused on mild-to-moderate acne and few studies have looked at the use of cosmeceuticals in more severe acne. Overall, adjunctive treatment with cosmeceuticals might reduce the side effect profile of standard therapies such as dryness, itching, scaling and erythema, promoting treatment compliance and improving acne outcomes.