What is benzoyl peroxide?
Benzoyl peroxide (BPO) is the most effective single acne medication to treat acne. It is a potent antibacterial, anti-inflammatory, and exfoliant, helping to unclog pores. The American Academy of Dermatology regards benzoyl peroxide (BPO) as the single most effective topical anti-acne treatment medication.
In addition to eliminating acne bacteria, it reduces the risk of the potential for bacterial resistance. Topical BPO and antibiotics act by reducing P. acnes concentrations and suppressing inflammation. Benzoyl peroxide was also found to reduce the excess sebum production in the skin and unclog clogged skin pores skin, reducing blackheads and whiteheads (keratolytic).
BPO is more effective than topical antibiotics at destroying bacteria (90% reduction in P. acnes in seven days). No bacterial resistance against BPO has been shown to date. As with all other effective acne topical treatments, BPO can cause some initial redness and dryness. These adverse effects can now be significantly reduced by personalizing the percentage of benzoyl used to the specific skin type.
Using specially formulated micronized benzoyl peroxide is more effective and less irritating than the classic large molecule benzoyl peroxide formulations. Skincare products such as cleansers and moisturizers that complement prescribed therapies can also improve treatment tolerability and adherence. In addition to its effect on acne, benzoyl peroxide has been used in other skin disorders, including rosacea, folliculitis including gram-negative folliculitis, pityrosporum folliculitis (fungal acne), and keratosis pilaris.
Because of its minimal systemic absorption, topical benzoyl peroxide is generally considered safe in children.
Benzoyl peroxide is the #1 topical ingredient recommended by the new American Academy of Dermatology treatment guidelines for acne. The American Academy of Dermatology (AAD) recommends BP for acne treatment based on evidence from multiple studies.
1. Efficacy and Safety of Benzoyl Peroxide for Acne Vulgaris: A randomized, double-blind, placebo-controlled study evaluated the long-term use of 2.5% and 5% benzoyl peroxide gels administered once daily for 52 weeks to Japanese patients with acne vulgaris. The study found both concentrations to be effective and safe for long-term treatment, with significant reductions in acne lesions and well-tolerated adverse effects, indicating the robust efficacy of BPO in managing acne over extended periods [(Kawashima et al., 2017).
2. Comparison of Antimicrobial Regimens for Acne: This study compared the efficacy of various antimicrobial regimens for mild to moderate facial acne, including topical benzoyl peroxide. The findings indicated that topical benzoyl peroxide was similarly effective in efficacy to other treatments, such as oral antibiotics and combined topical therapies, underscoring its value as a standalone treatment option for acne vulgaris (Ozolins et al., 2004).
3. Placebo-Controlled Study of BPO Gel in Acne Vulgaris: A multicenter study conducted to investigate the efficacy and safety of BPO gel, administered once daily for 12 weeks, showed significant improvement in acne symptoms compared to placebo. The study demonstrated the efficacy of BPO gel in reducing both inflammatory and non-inflammatory acne lesions, providing substantial evidence of its effectiveness as a monotherapy for acne vulgaris (Kawashima et al., 2017).
These studies confirm the clinical efficacy of benzoyl peroxide as a monotherapy in treating acne vulgaris, highlighting its role as an essential component of acne management strategies due to its significant lesion reduction and safety profile over both short and long-term usage periods.
What is the best benzoyl peroxide product?
Benzoyl peroxide products differ in efficacy and irritation. These differences depend on the type of benzoyl peroxide (standard or micronized), the vehicle (a cream gel or wash), the percent of benzoyl peroxide in the products, and the boosters added to the benzoyl peroxide (i.e., anti-inflammatory plant extracts).
Benzoyl peroxide gel preparations:
This type of benzoyl peroxide is used in older prescription and over-the-counter benzoyl peroxide products and is the most irritating. Most of those gels contain regular benzoyl peroxide, which is more irritating and less effective than micronized (micromolecule) benzoyl peroxide. Some first-generation simple benzoyl gel products are Persa Gel, Brevoxyl, Benzac gel, and Panoxyl gel. The new generation of benzoyl peroxide includes, in addition to, micronized (micromolecule) benzoyl peroxide. These other ingredients can increase the efficacy of the acne treatment, reduce skin irritation, and help prevent and fade post-acne dark spots.
What are the unique benefits of MDacne's Benzoyl peroxide treatment cream?
- Made of micronized benzoyl peroxide, it helps increase efficacy and reduce irritation.
- A cream-based formula that helps hydrate the skin and reduce dryness and redness
In addition to benzoyl peroxide, it contains:
- Ascorbic Acid, or Vitamin C, helps lighten post-acne dark spots and supports skin cell renewal, enhancing your skin's overall appearance.
- Camellia Sinensis, or Green Tea, contains potent antioxidants and anti-inflammatory properties that can help reduce inflammation and redness associated with acne. It also reduces sebum production, decreasing the likelihood of future acne breakouts.
- Cucumis Sativus, commonly known as Cucumber Extract, hydrates and soothes irritated skin. It's an excellent ingredient for calming inflamed acne and reducing puffiness.
- Glycyrrhiza Glabra or Licorice Root Extract is another excellent ingredient for post-acne dark spots. It inhibits excessive melanin production, helping to fade hyperpigmentation, brighten the skin, and even out the skin tone.
- Glycerin, a humectant that locks in skin moisture, helps maintain its barrier and keeps it hydrated. This ingredient promotes skin healing and can soothe acne-induced irritation.
- Tocopheryl Acetate, or Vitamin E, is an antioxidant that protects skin cells from damage. It also has anti-inflammatory properties, which can help soothe acne inflammation.
Benzoyl peroxide washes:
This type of cleanser and wash is less effective than benzoyl peroxide creams or gel left on the skin all night. Another choice for people with acne is salicylic acid cleansers, which are more effective and less irritating than benzoyl peroxide washes.
Combining benzoyl peroxide with other ingredients:
A few topical medications use a combination of benzoyl peroxide with other ingredients. The common additions are clindamycin, erythromycin, and adapalene. Combining benzoyl peroxide with clindamycin and erythromycin (Brand names: Benzaclin, Benzamycin) is believed to be more effective than regular BPO gel products. Still, most people will not be worth the significantly higher cost. Combining benzoyl peroxide with adapalene or other retinoids (Brand names: Epiduo and Tactupump) is not a good idea for most people with acne. Adding adapalene frequently causes significant redness, irritation, and itch that requires a pause in the treatment.
Combining benzoyl peroxide with active plant-based complexes
The formulations of benzoyl peroxide combine micronized BPO with active plant-based complexes. One of the best examples of Mdacne benzoyl peroxide treatment creams (2.5% and 5%) that contain, in addition to BPO, Vitamin C, Green Tea, and Licorice Root Extract that can help reduce the redness associated with benzoyl peroxide treatment and help fade post-acne dark spots (licorice).
Should I use benzoyl peroxide 2.5%, 5%, or 10% for my acne?
A higher percentage is not necessarily more effective. It was proven in a few studies that Benzoyl peroxide is just as effective in treating acne at 2.5% and 5% as it is at 10%. The difference is that the higher percentages will usually over-irritate the skin and increase skin redness and dryness.
How to use benzoyl peroxide?
Benzoyl peroxide should be used as part of complete personalized acne treatment. The optimal treatment will include a medicated cleanser in the morning and evening, a daily active moisturizer in the morning, and treatment cream with benzoyl peroxide (or another medical grade anti-acne active ingredients) at night.
For best results, apply a "pea-sized" amount of your benzoyl peroxide night cream to your finger and touch the six areas of your face, twice on your forehead, once on each cheek, once on your nose, and once on your chin. Ensure you apply the creams to the affected area, not just to single pimples.
Gently massage it into your whole face (avoiding the areas on the neck, around the eyes, your mouth, or the edges of your nose, as the skin in these areas is thin and very sensitive). If you have dry skin, combine a small quantity of the night treatment cream ("pea-sized") with an equal amount of moisturizer (labeled day) in your palm before you apply it. This will result in a diluted, milder treatment cream.
Leave BPO cream on your skin overnight until you perform your morning routine.
What are the side effects of using benzoyl peroxide?
At higher concentrations and in people with sensitive skin or eczema, topical benzoyl peroxide causes mild dryness, erythema, and scaling. In rare cases, BPO can cause an allergic reaction. People allergic to cinnamon and other benzoic acid derivatives should be cautious using benzoyl peroxide as cross-allergy may occur. Benzoyl peroxide should not be applied to the hypersensitive skin around the eyes, nose, and mouth. BPO is known to bleach non-white fabrics and synthetic hair but will not bleach the skin.
What should you expect when you are using benzoyl peroxide?
Week 1: The Start
- Fights off acne bacteria right away.
- Your skin might feel dry or itchy, but that's normal.
Week 2: Getting Used to It
- You'll see less redness and fewer pimples.
- Your skin will get used to the product, so there is less dryness.
Week 4: Looking Better
- You'll notice way fewer breakouts.
- Your skin will start to feel smoother.
Week 12: Keeping It Up
- By now, your skin should look and feel a lot better.
- You'll also be more comfortable using the product, so there are fewer side effects.
Week 24: Almost There
- Your skin should be much clearer and stay that way.
- It will also feel softer and look better overall.
Long-term: Just Maintenance
- Your skin should stay clear if you keep using the product.
- You might even need less of it to keep things looking good.
- Remember, everyone's skin is different, so your experience may vary.
Treatment of rosacea with benzoyl peroxide
Benzoyl peroxide is one of the most effective treatments for moderate to severe rosacea. People with papulopustular rosacea should look for benzoyl peroxide 2.5% creams to reduce skin irritation. BPO with anti-inflammatory plants-based complexes such as aloe vera and green tea seems to achieve the best results.
Benzoyl Peroxide 2.5% (Amazon).
Benzoyl Peroxide 5% (Amazon).
Body Acne Benzoyl Peroxide 5%
Hydrating Acne Cleanser (Amazon).
Oil-free Sunscreen (Amazon).
Acne Supplements for Teen Acne (Amazon).
Acne Supplements for Adult Acne (Amazon).
- A call to limit antibiotic use in acne. J Drugs Dermatol. 2013;12:1331–1332.
- Antibiotic stewardship in dermatology: limiting antibiotic use in acne. Eur J Dermatol. 2014;24:330–334.
- Management of acne: a report from a Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol. 2003;49:S1–S37.
- Anti-inflammatory actions of benzoyl peroxide: effects on leucocytes' generation of reactive oxygen species and the activity of protein kinase C and calmodulin. Br J Dermatol. 1994;130:569–575.
- The short-term treatment of acne vulgaris with benzoyl peroxide: effects on the surface and follicular cutaneous microflora. Br J Dermatol. 1995;132:204–208.
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