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.

The first part of the study shows that four commercial sun protection SPF 50 products provide statistically significant (all p < 0.021) protection by reducing the amount of UV-induced mitochondrial (mtDNA) damage in human dermal fibroblast skin cells (i.e., 320% protection). mtDNA damage has been shown to be an effective and reliable biomarker of skin damage and plays a key role in the ageing process. The second part of the study investigates a sub-set, namely two of the four commercial sun protection products. Both products significantly protect (both p < 0.014) against the longer wavelength blue light induced decrease in a different biomarker, namely the viability of human dermal fibroblast skin cells.

Introduction: Extrinsic skin damage is often a result of oxidative stress caused by exposure to environmental factors such as ultraviolet (UV) radiation, ozone (O₃), and various pollutants. As a result, topical antioxidants have been evaluated for their effectiveness in mitigating or reversing skin damage caused by environmental factors. Topical antioxidants containing a combination of l-ascorbic acid, tocopherol, and ferulic acid have significantly improved markers of skin health after exposure to environment-induced skin damage. However, research suggests that l-ascorbic acid and tocopherol tend to be relatively unstable, possibly affecting their efficacy against outdoor stressor damage. It has been shown that ferulic acid significantly improves the stability of both l-ascorbic acid and tocopherol, but its long-term stabilization effects on these antioxidants are relatively unknown. Material and Methods: This study evaluated the time-dependent effectiveness of a topical antioxidant mix containing 15% l-ascorbic acid, 1% tocopherol, and 0.5% ferulic acid (AOX) on UV-induced skin damage. Skin biopsies (12 mm, n = 60) were placed in a 6-well plate with medium and incubated at 37 °C and 5% CO₂ overnight. The day after, skin samples were pretreated with 10 µL of differently aged AOX (0-, 6-, 12-, and 36-month-old) and then exposed to different doses of UV light (100, 200, 400 mJ/cm²) daily over four days. AOX formulations were stored in a cool, dry, and dark place at approximately 20–22 °C during the whole study. This study evaluated 4-hydroxynonenal (4-HNE) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) as oxidative damage and skin DNA damage markers, Collagen1 and Filaggrin as skin structure, and IL-8 and Nrf2 as inflammatory and defensive response. Results: UV exposure significantly increased oxidative and inflammatory markers in human skin explants affecting also filaggrin and collagen levels. However, pre-treatment with the antioxidant formulation, particularly in its younger formulations (0-, 6-, and 12-month-old), significantly reduced the damaging effect of UV. Additionally, all antioxidant formulations effectively mitigated UV-induced damage across all doses. Conclusions: Our results indicate that pre-treatment with this formulation consistently reduces UV-induced oxidative damage and DNA damage in human skin explants, regardless of the formulation age and the discoloration state. Although effective, the protective capacity of aged formulations may be reduced only when extreme UV exposure is tested, a condition that is unlikely to occur under typical environmental conditions. These results support ferulic acid as a stabilization agent for topical antioxidant mixtures.

Visible light (VL) accounts for approximately 50% of the solar radiation reaching Earth’s surface and has emerged as a major contributor to skin photoaging and pigmentation disorders, particularly in individuals with darker Fitzpatrick skin phototypes. Increasing evidence suggests that VL exposure induces oxidative stress, inflammation, and melanogenesis by generating reactive oxygen species. In this study, we investigated the protective effects of a topical antioxidant formulation (AOX Mix) containing 15% ascorbic acid, 0.5% ferulic acid, and 1% tocopherol against VL exposure in ex vivo skin biopsies from donors with Fitzpatrick skin phototypes IV–V. To preserve physiological tissue tension and closely replicate in vivo skin responses, human skin explants were maintained using the TenSkin™ culture system. Samples were pretreated with AOX Mix for 30 min, then exposed to VL for 8 h, and collected on Days 2 and 7 for histological and molecular analyses. Our results demonstrated that prolonged exposure to VL disrupted redox homeostasis and induced structural alterations in skin explants, accompanied by increased markers of oxidative stress and pigmentation. In contrast, pre-treatment with AOX Mix significantly attenuated these effects, preserving tissue architecture and reducing molecular indicators of photodamage. In addition, we observed the co-localization of 4-hydroxynonenal and collagen type I, suggesting that oxidative post-translational modification of collagen may contribute to its loss. These findings suggest that antioxidant-based interventions, such as AOX Mix, may be a promising strategy for protecting dark skin against VL exposure.