Dermatologists’ perspectives on daily gentle exfoliation for sensitive and oily/acne-prone skin: Insights from a national survey

Objectives: Sensitive skin, now recognized as a distinct clinical phenotype, affects nearly 60–70% of women and 50–60% of men globally, with Indians reporting among the highest levels of skin sensitivity. Patients with sensitive and oily/acne-prone skin often experience compromised barrier function, heightened reactivity, and pigmentation concerns, necessitating gentle yet effective skincare strategies. Exfoliation plays a critical role in epidermal renewal and pigmentation control, but conventional methods risk irritation and post-inflammatory hyperpigmentation in melanin-rich populations. To address this, micro-dosed combinations of alpha-hydroxy acids, beta-hydroxy acids, and polyhydroxy acids have emerged as promising options for safe daily exfoliation. This survey aimed to evaluate the clinical positioning of the Cetaphil Gentle Exfoliating salicylic acid (SA) range, discern formulation preferences, and identify perceived challenges and opportunities. Materials and Methods: A cross-sectional, structured questionnaire-based survey was conducted among 106 dermatologists attending DERMACON 2025. Participants received a scientific briefing on the Cetaphil Gentle Exfoliating SA range (cleanser and lotion) before completing an eight-item survey. Questions explored therapeutic use, formulation preferences, potential indications, and clinical reservations. Responses were anonymized and analyzed using descriptive statistics, while open-ended feedback was thematically categorized. Results: Most dermatologists (88.7%) identified oily and acne-prone skin as the primary indication for daily gentle exfoliation, highlighting its role in sebum regulation, comedogenesis prevention, and texture improvement. Notably, 63.2% also endorsed its use in sensitive skin, reflecting increasing confidence in micro-dosed exfoliant formulations. Additional reported indications included keratosis pilaris (29.2%), post-inflammatory pigmentation, rough/bumpy skin, and post-acne maintenance. Nearly half of the respondents (46.2%) preferred a dual regimen combining cleanser and lotion, citing synergistic benefits of cleansing, exfoliation, hydration, and extended contact time. Cleanser-only use was favored by 31.1%, primarily for simplicity and compliance, while 16.9% preferred the lotion alone. Only 5.7% of dermatologists avoided exfoliation, typically in patients with active dermatitis or marked barrier compromise. Concerns raised included the need for India-specific clinical data ( n = 17), differentiation from cosmetic exfoliants ( n = 9), and guidance on combining with other actives such as retinoids ( n = 6). Conclusions: Indian dermatologists demonstrated strong acceptance of daily, gentle chemical exfoliation for oily/acne-prone and sensitive skin, with a clear preference for combination regimens that balance efficacy with barrier support. The incorporation of mandelic acid, salicylic acid, and gluconolactone in low concentrations was perceived as an innovation enabling safe exfoliation in populations historically considered high risk. These findings highlight a paradigm shift toward barrier-preserving exfoliation strategies in Indian dermatology practice and reinforce the therapeutic potential of micro-dosed acid formulations for sensitive and acne-prone skin, while addressing evidence gaps specific to Indian skin types.