Soaps are of alkaline pH and are known irritants, causing itching, dryness and redness; acidic soap-free cleansers may therefore be preferential. Aggressive use of abrasives may irritate skin and for that reason common sense suggests that they should not be used in conjunction with topical agents such as benzoyl peroxide, which sensitise the skin, unless tolerance has initially been demonstrated. Dermatological reactions are idiosyncratic and cannot be predicted and the patient should be advised to discontinue use immediately if irritation develops. Like any topical agent, it is possible that antibacterial cleansers and abrasives are less suitable in individuals with sensitive skin. The literature does not support a link between the use of topical antimicrobials and the emergence of antiseptic or antibiotic resistance.22
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