International Expert Consensus on Integrated Skincare Active Ingredients for Pretreatment and Posttreatment Use With Medical Aesthetic Procedures to Enhance Skin Benefits

BACKGROUND: Integrated skincare (ISC) combines dermocosmetics with medical aesthetic procedures to improve outcomes. However, guidance on selecting appropriate active ingredients across different procedure types and phases remains limited. AIMS: To provide international guidance on appropriate ISC actives for use with aesthetic procedures. METHODS: In a simplified Delphi study, 14 experts evaluated 44 actives for use across four procedure categories (ablative energy-based, non-ablative energy-based, non-energy-based procedures with or without skin barrier disruption) at four time points (pretreatment, peri-treatment, aftercare, and follow-up ≥ 1 week post-procedure). The panelists also ranked their top five preferred actives for each procedure category and time point. RESULTS: Ceramides, cholesterol, hyaluronic acid, niacinamide, and peptides were deemed appropriate across all procedure categories and all time points. Azelaic acid, benzoyl peroxide, cysteamine, glycolic acid, hydroquinone, lactic acid, retinoids, and salicylic acid were identified as unsuitable for use on treatment day. Ceramides and hyaluronic acid were highly ranked for pre-treatment, peri-treatment and aftercare, while retinoids and ferulic acid were highly ranked for pretreatment and followup. Vitamin C was ranked in the top 5 across all procedure categories and time points, except at pretreatment for non-energy-based without skin barrier damage. CONCLUSIONS: Safety and tolerability are primary considerations when selecting ISC actives. Ingredients with higher irritation potential, such as retinoids and acids, should be avoided during the healing phase (on treatment day and during short-term aftercare) due to risk of irritation, as well as post-inflammatory hyperpigmentation in skin of color.