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 the 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 treatment, it's used can cause some initial redness and dryness. These adverse effects can now be significantly reduced by personalizing the percent of benzoyl used to the specific skin type.
Using specially formulated micronized forms of 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 regarded as safe in children.
What is the best benzoyl peroxide product?
Benzoyl peroxide products differ in efficacy and irritation. These differences depend on the type of benzoyl peroxide (normal 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 gel contains regular benzoyl peroxide, which is more irritating and less effective than the micronized (micromolecule) benzoyl peroxide. Some first-generation simple benzoyl gel products are Persa Gel, Brevoxyl, Benzac gel, and Panoxyl gel.
Benzoyl peroxide washes:
This type of cleanser and wash is less effective than benzoyl peroxide creams or gel left on the skin all night. Abbgter choice for people with acne is salicylic acid cleansers that are more effective and less irritating than benzoyl processed washes.
Benzoyl peroxide cream preparations:
The newest type of cream-based benzoyl peroxide preparations is less irritating than benzoyl peroxide gels with the same percentage. Many benzoyl products are based on micronized benzoyl peroxide and include plant extracts to reduce inflammation and skin irritation.
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, Tactupump) is not a good idea for most people with acne. The addition of 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 a complete personalized acne treatment. The optimal treatment will include a medicated cleanser used in the morning and evening, a daily active moisturizer applied 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. Make sure you apply the creams to the whole affected area and 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 the moisturizer (labeled day) in your palm before you apply it. This will result in a diluted, more mild 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 very 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 it will not bleach the skin.
Treatment of rosacea with benzoyl peroxide
It seems that 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.
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- 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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