A 2025 Delphi study narrowed 318 candidate ingredients to 23 that 62 dermatologists agreed on. Here is how the list was built, what its evidence levels mean, and what it cannot tell you.
· 4 min read
Skincare shelves hold thousands of actives, and every brand has its own favorites. A 2025 paper in the Journal of the American Academy of Dermatology tried something different: it asked board-level experts which topical ingredients they actually recommend, and measured where they agreed. The result is a useful short list, and also a lesson in how to read any list that claims to be expert approved.
The authors started with a literature review that produced a long list of 318 ingredients. A panel of 17 dermatologists cut that to 83. A second group of 62 dermatologists at 43 centers then completed two rounds of a Delphi survey, a method in which experts answer anonymously, see the group's results, and answer again. Consensus was reached for 23 ingredients. Put differently, from 318 candidates, 23 cleared the bar, which is about 7 percent.
That funnel matters. It means the final list reflects ingredients experts can name and defend, not everything that exists. A trendy new active may simply not have been on the long list, and absence from the 23 is not a verdict against it.
The abstract names eight of the 23, each tied to concerns the panel considered: fine lines and wrinkles, blemish-prone skin, redness, dark spots, large pores, dry skin and oily skin. The ones spelled out include:
The abstract does not list the remaining fifteen, so any article that claims to recite all 23 from the abstract alone is guessing. The full text sits behind the journal.
The authors report that most consensus ingredients were supported by level 1b or 2b evidence, and that some were based on expert opinion. Those levels are a standard evidence-grading scale: 1b is generally a well-designed individual randomized trial, and 2b is a lower-quality cohort or trial. That is respectable, but it is not the same as every ingredient having large, long trials. The phrase 'some were based on expert opinion' is the honest hedge to carry forward.
Retinoids illustrate how evidence varies inside one family. A 1998 randomized trial in 125 adults compared a 0.05 percent retinaldehyde cream, a 0.05 percent retinoic acid cream, and a vehicle, and measured wrinkle and roughness features on the crow's-feet area with profilometry. Both actives showed a significant reduction at week 18, the vehicle did not, and the retinoic acid group had more local irritation. A 2019 review adds that the optimal concentration balancing irritation against effectiveness for retinol has not been determined. So a retinoid can be on a consensus list and still leave practical questions open.
It cannot rank products. The Delphi was about ingredients, not formulas, strengths or delivery. The same ingredient can behave very differently depending on concentration, pH and base.
It cannot tell you about combinations. Two ingredients can each be on the list while their pairing is untested, as is often the case with niacinamide and vitamin C layering.
It reflects the panel's setting. The participants were cosmetic dermatologists working in clinical practice, so the list leans toward ingredients available in products they would discuss with patients. It says less about newer launches.
It is not personalized. Consensus about what works for a concern on average does not predict how your skin looks after eight weeks.
A short list is only useful if you act on it carefully. A reasonable approach:
Twenty-three ingredients out of 318 is a genuine signal about where expert agreement lies, and it is worth using as a filter when a new product makes sweeping promises. Treat it as a starting shortlist: check the concentration, the formula, and the evidence level, and remember that some items on the list rest partly on expert opinion. If you are pregnant or planning to be, talk to your doctor about products during pregnancy before adding vitamin A derivatives or other actives.
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