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Review
. 2023 Jun;22(6):1919-1928.
doi: 10.1111/jocd.15726. Epub 2023 Mar 22.

Sun exposure, a relevant exposome factor in acne patients and how photoprotection can improve outcomes

J Piquero-Casals  1 , D Morgado-Carrasco  2 , E Rozas-Muñoz  3 , J F Mir-Bonafé  4 , C Trullàs  5 , E Jourdan  5 , J Piquero-Martin  6 , C C Zouboulis  7 , J Krutmann  8   9
Affiliations
Review

Sun exposure, a relevant exposome factor in acne patients and how photoprotection can improve outcomes

J Piquero-Casals et al. J Cosmet Dermatol. 2023 Jun.

Abstract

Background: Acne pathophysiology includes a complex interaction among inflammatory mediators, hyperseborrhea, alteration of keratinization and follicular colonization by Propionibacterium acnes.

Aims: To describe the impact of the exposome on acne and how photoprotection can improve outcomes.

Methods: 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 "acne," "sunscreens," "photoprotection," "cosmetics," "cosmeceuticals," "pathogenesis," "etiology," "exposome," "sunlight," "stress," "lack of sleep," "diet," "postinflammatory hyperpigmentation," "pollution," "exposome," "ultraviolet radiation," and "visible light."

Results: 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-inflammatory hyperpigmentation and/or post-inflammatory 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-inflammatory 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.

Conclusions: The exposome and solar radiation can trigger or worsen acne. UV light can induce post-inflammatory 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-inflammatory hyperpigmentation/erythema.

Keywords: acne; photoprotection; post-inflammatory hyperpigmentation; sunscreens; ultraviolet radiation.

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References

REFERENCES

    1. Lynn DD, Umari T, Dunnick CA, Dellavalle RP. The epidemiology of acne vulgaris in late adolescence. Adolesc Health Med Ther. 2016;7:13-25.
    1. Gollnick HPM, Dreno B. Pathophysiology and management of acne. J Eur Acad Dermatol Venereol. 2015;29(4):1-2.
    1. Passeron T, Krutmann J, Andersen ML, Katta R, Zouboulis CC. Clinical and biological impact of the exposome on the skin. J Eur Acad Dermatol Venereol. 2020;34(4):4-25.
    1. Yang J, Yang H, Xu A, He L. A review of advancement on influencing factors of acne: an emphasis on environment characteristics. Front Public Health. 2020;8:450.
    1. Dréno B, Dagnelie MA, Khammari A, Corvec S. The skin microbiome: a new actor in inflammatory acne. Am J Clin Dermatol. 2020;21:18-24.

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