Egyptian National Consensus on Dermocosmetic Ingredient Selection Across Common Dermatology Scenarios: A RAND/UCLA Appropriateness Study.

INTRODUCTION

Dermocosmetics are widely used to complement dermatologic care, yet context-specific guidance remains limited for populations with Fitzpatrick skin types III-V. We convened a national expert panel to generate transparent, reproducible recommendations across ten common clinical scenarios.

METHODS

Egyptian dermatologists participated in round 1 (national survey, n = 601) and round 2 (expert panel, n = 16), both with anonymous ratings and inter-round feedback, using the RAND/UCLA appropriateness method (median bands 1-3/4-6/7-9; disagreement index (DI) = interpercentile range (IPR)/IPR adjusted for symmetry (IPRAS); DI > 1.0 = disagreement). Per-item outputs included median, P30, P70, IPR (30-70), asymmetry Index (AI), IPRAS, DI, and final category (appropriate/uncertain/inappropriate). We additionally benchmarked classifications against prior consensus, guidelines, and key evidence frameworks.

RESULTS

Across ten vignettes and 30 ingredients (30 ingredients × 10 scenarios = 300 items; multiple raters per item in round 1), 158 (52.7%) items were appropriate (median ≥ 7; DI ≤ 1.0), 135 (45.0%) were uncertain, and 7 (2.3%) were inappropriate. Photoprotection had the highest appropriateness across scenarios (broad-spectrum/tinted SPF), with a small number of DI-flagged uncertain exceptions. Hydration/barrier agents (e.g., hyaluronic acid, peptides, ceramides) were appropriate in stress-aging, post-laser, and post-procedure care. Pigment modulators (tranexamic acid, arbutin, niacinamide, vitamin C, glabridin) were appropriate in melasma/post-inflammatory hyperpigmentation and chronic sun-induced pigmentation. Classical retinoids were inappropriate for postpartum/breastfeeding and immediate post-procedure; lower-irritancy retinoid esters were context-dependent. Botanicals showed inconsistent support. Panel disagreement (DI > 1.0) declined from 38.3% in round 1 to 15.7% (47/300) in round 2. Patterns largely aligned with prior consensus; visible-light-mitigating photoprotection and timing-specific retinoid use were emphasized for darker phototypes.

CONCLUSION

We provide a transparent, regionally relevant framework for dermocosmetic ingredient selection. Sun protection and barrier support are foundational; pigment modulators are scenario-specific; retinoids require selective use; botanicals remain adjunctive.