What active ingredients should I use in my skin care routine?

Optimal Active Ingredients for Skincare Routine

For an effective skincare routine, use a combination of topical retinoids (tretinoin, adapalene, or tazarotene) and benzoyl peroxide as your primary active ingredients, supplemented with ceramides and niacinamide for barrier protection. 1, 2, 3

Core Active Ingredients

First-Line Actives

• Topical retinoids (adapalene 0.1%, tretinoin 0.025-0.1%, or tazarotene 0.05-0.1%) are cornerstone ingredients that normalize follicular keratinization, resolve microcomedones, and provide anti-inflammatory benefits 1, 2, 3
• Benzoyl peroxide (2.5-5%) is highly effective for its antimicrobial properties against C. acnes with no reported bacterial resistance 2, 3, 4
• These two ingredients work synergistically and are recommended as first-line therapy by the American Academy of Dermatology 2, 3

Supporting Actives

• Salicylic acid (0.5-2%) functions as a comedolytic agent and is particularly helpful for mild comedonal acne 1, 5
• Azelaic acid (20%) provides mild comedolytic, antibacterial, and anti-inflammatory effects, with additional benefits for hyperpigmentation 1, 3
• Niacinamide (up to 5%) helps restore barrier function, reduce inflammation, and improve overall skin appearance 6, 7

Formulation Selection Based on Skin Type

For Oily/Acne-Prone Skin

• Use adapalene 0.1% gel (available over-the-counter) or prescription-strength retinoids 2, 8, 9
• Incorporate benzoyl peroxide 2.5-5% wash or leave-on formulation 3, 4
• Consider fixed-combination products (e.g., clindamycin 1%/BP 5%) for enhanced compliance if inflammation is present 1

For Dry/Sensitive Skin

• Start with lower-strength retinoids (tretinoin 0.025% cream or adapalene 0.1%) 1, 8
• Use ceramide-containing cleansers and moisturizers to support barrier function 6, 10
• Consider azelaic acid as a gentler alternative, especially if hyperpigmentation is a concern 1

Application Protocol

Morning Routine

• Gentle cleanser with or without salicylic acid 5
• Benzoyl peroxide product (wash or leave-on) 3, 4
• Ceramide and niacinamide-containing moisturizer 6, 10
• Sunscreen (essential when using retinoids due to photosensitivity) 2

Evening Routine

• Gentle cleanser 10
• Topical retinoid (tretinoin, adapalene, or tazarotene) 1, 2, 8
• Ceramide-containing moisturizer to mitigate potential irritation 6, 10

Important Considerations

Potential Side Effects and Management

• Retinoids may cause initial irritation, dryness, and photosensitivity; start with lower concentrations and gradually increase frequency 1, 2
• Benzoyl peroxide can bleach clothing and bedding; wear old clothing or white pajamas when applying 2
• Ceramide-containing products significantly reduce severity and incidence of dryness, erythema, and scaling while restoring barrier function 10

Common Pitfalls to Avoid

• Using topical antibiotics as monotherapy increases risk of bacterial resistance; always combine with benzoyl peroxide 1, 3
• Stopping treatment once skin clears is not recommended; maintenance therapy with topical retinoids is essential to prevent relapse 2, 3
• Neglecting barrier repair can lead to increased irritation and treatment discontinuation; ceramide-containing products help maintain compliance 6, 10

Evidence-Based Combinations

• A ceramide-containing skincare routine paired with adapalene/benzoyl peroxide significantly reduces barrier damage and improves treatment outcomes 10
• Combining retinoids with benzoyl peroxide provides superior efficacy compared to either agent alone 2, 3
• Adding niacinamide to a ceramide-containing moisturizer enhances barrier repair and reduces irritation from active treatments 6, 7