From the Guidelines
Benzoyl peroxide (BP) is a highly effective first-line topical treatment for acne that works by killing acne-causing bacteria and removing excess oil and dead skin cells that clog pores, as recommended by the guidelines of care for the management of acne vulgaris 1.
Key Points About Benzoyl Peroxide
- It's available over-the-counter in strengths ranging from 2.5% to 10%, with most dermatologists recommending starting with lower concentrations (2.5% or 5%) to minimize irritation while still providing benefits.
- Apply BP once or twice daily to clean, dry skin, covering the entire acne-prone area rather than just spot-treating individual pimples.
- When beginning treatment, start with every other day application and gradually increase frequency as your skin adjusts.
- BP can cause dryness, redness, and peeling, especially during the first few weeks of use, so pair it with a non-comedogenic moisturizer.
- It may also bleach fabrics, so use white towels and pillowcases and allow it to dry completely before dressing.
Mechanism of Action and Benefits
BP works through its oxidizing properties, releasing oxygen that kills Propionibacterium acnes bacteria while also having anti-inflammatory effects and helping to prevent the development of bacterial resistance, making it particularly valuable in long-term acne management 1.
Recommendations and Guidelines
The guidelines of care for the management of acne vulgaris recommend BP for acne treatment based on moderate certainty evidence from 8 studies 1.
Important Considerations
- Clinically visible improvements will normally occur by the third week of therapy, with maximum lesion reduction expected after approximately 8 to 12 weeks of drug use 1.
- BP is contraindicated in patients who have shown hypersensitivity to benzoyl peroxide or to any of the other ingredients in the products 1.
- Adverse effects include hypersensitivity reactions, contact sensitization reactions, excessive erythema, and peeling 1.
From the FDA Drug Label
Active ingredient Benzoyl peroxide 5% Benzoyl peroxide 10% Purpose Acne treatment Use for the treatment of acne
BP in the context of acne treatment refers to Benzoyl Peroxide, a topical medication used to treat acne. It is available in different concentrations, such as 5% and 10% 2. The primary purpose of Benzoyl Peroxide is to help clear up acne lesions and prevent new ones from forming 2.
From the Research
Definition and Mechanism of BP
- BP stands for Benzoyl Peroxide, a widely used topical acne treatment [(3,4,5,6,7)].
- It has significant antibacterial, antikeratolytic, and comedolytic activity 3.
- The mechanism of action is the reduction of anaerobe bacteria by strong oxidation processes 5.
Efficacy and Concentrations
- BP is equally effective at concentrations of 2.5%, 5%, and 10% [(4,6)].
- However, higher concentrations are associated with more adverse effects, such as irritant dermatitis [(4,5,6)].
- A concentration of 5% is often sufficient to control acne of grades I to II 5.
Combination Therapy
- BP can be used in combination with topical retinoids, antibiotics, and tertiary amines to enhance its efficacy [(3,4,6)].
- Combination therapy with BP and topical antibiotics shows less bacterial resistance than topical antibiotics alone 5.
- BP is also more efficacious when used in combination with topical retinoids than as a monotherapy 6.
Safety and Tolerability
- BP has a proven track record of safety and efficacy for the treatment of acne 6.
- Novel vehicles, such as microparticle delivery systems and hydrophase or urea-based formulations, can increase the tolerability of BP without sacrificing efficacy 6.
- BP can bleach clothes and hair, and its use should be taken into consideration 5.