How benzoyl peroxide can be used to treat acne

Benzoyl peroxide is one of the most important and well-known drug formulations available for topical acne treatment. It is a strong anti microbial and has slight anti-inflammatory and anticomedogenic effect and initial response is obtained in as early as five days. This makes it an excellent first choice medication.

Side effects:

Benzoyl peroxide is an irritant and can bleach clothing and bedding. Side effects therefore generally involve irritant dermatitis with erythema scaling and itching. True contact sensitivity and photosensitivity is possible but very rare. These side effects can, however, be avoided or lessened by less frequent application. Also, 2.5-5% water-based benzoyl peroxide preparations can cause significantly less skin irritation than preparations based on alcohol, with no loss in efficacy.

Treatment with benzoyl peroxide alone

Varying concentrations of benzoyl peroxide have been studied. It was found that of 2.5,5 and 10% concentrations, 2.5% has as effective with less drying and the least local side effects compared with the other two applications. Hence 2.5% is the more commonly used formulation.

Benzoyl peroxide in combination therapy

Prolonged treatment with antibiotics can result in bacteria developing resistance to the antibiotic. This decreases the efficacy of the drug. Benzoyl peroxide in combination with antibiotics is known to reduce the incidence of bacterial resistance, and also reduces the doses of therapy required to achieve similar results. Further, combination therapy has been shown to be more effective and better tolerated than with benzoyl peroxide alone. In one study combination of erythromycin 3% and benzoyl peroxide 5% led to reduced antioxidant enzyme activities in the leukocytes of acne spots, compared to 5% benzoyl peroxide alone which showed no changes.

New premixed formulations of benzoyl peroxide and topical antibiotics have now been introduced. These formulations are more convenient as they are stable at room temperature and do not require refrigeration. The premixed combination products include erythromycin 3% and benzoyl peroxide 5% or clindamycin 1% and benzoyl peroxide 5%.

Overall therefore, benzoyl peroxide is an effective acne treatment, both alone and in combination. However benzoyl peroxide should be used in combination whereever possible since it reduces the still existing antibiotic resistant populations and decreases the emergence of new bacterial resistance.