New Global Consensus on Integrated Skin Care Hopes to Optimize Aesthetic Outcomes

An international panel of dermatology and aesthetic medicine experts has developed new consensus guidance on the use of integrated skincare (ISC) active ingredients before, during, and after medical aesthetic procedures.¹ The recommendations, developed through a simplified Delphi process, aim to help clinicians select topical ingredients that support healing, reduce irritation, and improve outcomes across a wide range of procedures.

ISC refers to the use of clinically validated skincare products alongside aesthetic procedures to prepare the skin, support barrier repair, and improve long-term cosmetic results. According to the authors, interest in ISC has increased as dermatologists and aesthetic clinicians seek ways to minimize downtime and reduce complications such as post-inflammatory hyperpigmentation (PIH), erythema, infection, and irritation.²

Global Methodology

The consensus panel included 14 international experts from 10 countries across 5 continents, including 13 board-certified dermatologists and 1 aesthetic physician. The group evaluated 44 topical active ingredients across 4 procedure categories: ablative energy-based procedures, non-ablative energy-based procedures, non-energy-based procedures without barrier disruption, and non-energy-based procedures with barrier disruption. Recommendations were assessed across 4 treatment phases:

• Pretreatment
• Treatment day
• Short-term aftercare
• Follow-up beginning at least 1 week after the procedure

The guidance was informed by a literature review that identified 68 clinical studies published between 2003 and 2025, including 46 randomized controlled trials. Notably, 66% of the studies included patients with skin of color (SOC), an important consideration given the higher risk of PIH in these populations.

Universal Ingredients for Peri-Procedural Care

Several ingredients achieved broad consensus for use across all procedure types and time points. Ceramides, cholesterol, hyaluronic acid, niacinamide, and peptides were consistently considered appropriate throughout the peri-procedural period. Panthenol and alpha-bisabolol were also viewed favorably across most settings, despite incomplete survey responses for some scenarios.

The panel identified ceramides and hyaluronic acid as especially useful during treatment and early aftercare because of their barrier-supportive and soothing properties. Vitamin C also ranked highly across nearly all procedure categories and treatment phases, except during pretreatment for non-energy-based procedures without barrier disruption. Ferulic acid and retinoids were strongly favored during pretreatment and longer-term follow-up phases.

The consensus emphasized that ingredient selection should vary according to the degree of skin barrier disruption and the stage of healing. During the immediate healing phase, safety and tolerability were prioritized over more aggressive rejuvenating effects.

MORE ON AESTHETICS

Navigating Barrier Disruption

As a result, several ingredients associated with irritation or inflammation were deemed inappropriate for use on treatment day across all procedure categories. These included azelaic acid, benzoyl peroxide, cysteamine, glycolic acid, hydroquinone, lactic acid, retinoids, and salicylic acid. In some cases, experts also recommended avoiding these ingredients during the first week of aftercare.

The panel noted that retinoids presented a notable contrast: while strongly recommended during pretreatment and long-term follow-up because of their effects on collagen production and cellular turnover, they were considered unsuitable during the acute healing phase because of irritation risk. Similar concerns applied to hydroquinone and exfoliating acids, particularly in patients with SOC who may be more susceptible to PIH.

The authors highlighted that some active ingredients may behave differently depending on the procedure and the degree of barrier disruption. For example, low molecular weight hyaluronic acid may penetrate more deeply and support wound healing, but it may also increase inflammation after ablative procedures.

Challenges and Areas for Future Research

Certain ingredients and product categories did not achieve consensus. These included some botanical extracts, exosomes, and growth factors. The panel cited variability in formulation quality, extraction methods, purity, and clinical evidence as major concerns. Although some studies suggested potential benefits from exosomes and topical growth factors in promoting healing and improving skin quality, more evidence is needed before these products can be routinely recommended.

The consensus also addressed botanical ingredients, noting that some formulations may provide anti-inflammatory or soothing effects, while others may increase the risk of contact dermatitis or irritation depending on extraction methods and ingredient composition.

Overall, the panel concluded that the recommendations provide practical guidance for clinicians integrating skincare with aesthetic procedures. The authors emphasized that ISC strategies should be tailored to procedure type, treatment timing, skin barrier status, and individual patient risk factors, particularly in patients with SOC. Future research, they noted, should focus on procedure-specific formulations, ingredient combinations, and personalized approaches based on skin type and underlying dermatologic conditions.

References

1. Bjerring P, Draelos ZD, Fabi SG, et al. International Expert Consensus on Integrated Skincare Active Ingredients for Pretreatment and Posttreatment Use With Medical Aesthetic Procedures to Enhance Skin Benefits. J Cosmet Dermatol. 2026;25(5):e70880. doi:10.1111/jocd.70880

2. Fabi S, Boen M, Weinstein Velez M, Woodward JA, Austin AH, Dayan S. Expert Roundtable on Skin Care Integration After Aesthetic Procedures: Consensus Recommendations. J Drugs Dermatol. 2025;24(1):47-53. doi:10.36849/JDD.7999