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Acne Vulgaris
Published in Charles Theisler, Adjuvant Medical Care, 2023
Benzoyl Peroxide: Medical treatment should begin with a benzoyl peroxide agent because these are available over the counter and have an extensive history of safety and efficacy. Products are available in a wide range of vehicles (soaps, lotions, gels) and strengths vary from 2.5% to 10%. Higher strengths dry the skin but otherwise are no more effective against acne than the lower strengths.2 Individuals with acne vulgaris should be aware that benzoyl peroxide reflects the base of treatment upon which other agents are added. For example, benzoyl peroxide plus oral and topical antibiotics and/ or retinoids are often combined in more severe cases.3
Use of Dermatologics during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Keratolytics, astringents, and defatting agents are largely over-the-counter preparations, and are used to treat acne and related dermatologic conditions (Box 13.3). No human reproduction studies for any of these agents are published, nor are animal teratology data. Topical use of benzoyl peroxide, resorcinol, and salicylic acid may result in systemic absorption, but no cases of adverse fetal effects are documented related to the topical route of delivery. Salicylates are discussed in detail in Chapter 8, Analgesics during pregnancy. Manufacturer data on salicylic acid was reported to be teratogenic in animals when used in large doses, several times that used in humans.
Benzoyl Peroxide
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Benzoyl peroxide is an organic compound in the peroxide family and one of the most important in terms of applications. In medicine, benzoyl peroxide is used as a topical treatment for acne, either in combination with antibiotics or as a single agent; it has also been used in burns and for the treatment of leg ulcers. Like most peroxides, benzoyl peroxide is a powerful bleaching agent. Contact with fabrics or hair can cause permanent color dampening almost immediately; even secondary contact can cause bleaching. Because of this quality, benzoyl peroxide is also used for bleaching flour and cheese in the food industry, bleaching of hair and for teeth whitening. Other applications include the cross-linking of polyester resins, an initiator for polymerization of (meth)acrylates in artificial nail material (1), in fillers, putties, plasters, modelling clay, adhesives and sealants, biocides (e.g. disinfecttants, pest control products), coating products, finger paints and inks and toners. Benzoyl peroxide is found naturally in cereals and cereal products (29).
Hidradenitis suppurativa for the nondermatology clinician
Published in Baylor University Medical Center Proceedings, 2020
Kavina Patel, Lucy Liu, Benjamin Ahn, Annika S. Silfvast-Kaiser, So Yeon Paek
Topical treatments for HS include skin cleansers, keratolytic agents, and antibiotics.10 There is evidence to support their use in Hurley stage I and mild stage II HS, as monotherapy, or in conjunction with other treatments.11–18 Benzoyl peroxide, chlorhexidine, and zinc pyrithione may be used in conjunction with other HS treatments. While all are lacking in formal evidence, these compounds are recommended by anecdotal evidence and expert opinion. Topical cleanser selection should be made with patient and clinician preference in mind and may be driven by cost and availability.13 Chlorhexidine should only be used on actively draining areas. Side effects of zinc pyrithione include skin irritation. Side effects of benzoyl peroxide and chlorhexidine include itching or burning, stinging or redness, swelling, peeling, and dryness. In the North American guidelines, zinc pyrithione and benzoyl peroxide are formally recommended, while chlorhexidine is presented as expert opinion.
Clinical evidence for washing and cleansers in acne vulgaris: a systematic review*
Published in Journal of Dermatological Treatment, 2018
Thomas Stringer, Arielle Nagler, Seth J. Orlow, Vikash S. Oza
Leave-on formulations of benzoyl peroxide (BP) are mainstays of treatment for mild to moderate acne. BP is purported to be toxic to Propionibacterium acnes, a valuable property in the setting of rising bacterial resistance (19). Cleanser use may be better tolerated due to leave-on side effects of BP such as irritation and bleaching of clothes. Five studies investigating BP cleansers met inclusion criteria. Three used P acnes colony counts as the primary outcome measure. A single-arm study of daily 6% BP cleanser in 30 healthy subjects resulted in decreases to facial colony counts and the number of erythromycin/tetracycline-resistant strains (20). A single-arm sequential study of 20 healthy subjects examining a 5.3% BP emollient foam cleanser daily for two weeks followed by one week of washout and thereafter 2 weeks of daily 8% BP cleanser on the back found substantial reduction of colony counts on the back (week 1: 1.9 log; week 2: 2.1 log) only after the period of 5.3% foam application (21). However, this may be attributable to study design, as no subjects received the 8% BP cleanser prior to the 5.3% BP foam. Finally, a 2012 study of 9.8% BP foam in 22 healthy subjects found that even a short (2 min) contact time produced high reductions of P acnes colony counts on the back (1.66 log) following 2 weeks of treatment (22). Taken together, these studies suggest that benzoyl peroxide washes and cleansers are effective in reducing P acnes colony counts.
Randomized, controlled trial testing the effectiveness and safety of 2.5% and 5% benzoyl peroxide for the treatment of pitted keratolysis
Published in Journal of Dermatological Treatment, 2021
Charussri Leeyaphan, Pichaya Limphoka, Rungsima Kiratiwongwan, Punyawee Ongsri, Sumanas Bunyaratavej
Topical benzoyl peroxide is an over-the-counter drug which is known as an off-label medication for PK (14). It has both aerobic and anaerobic antibacterial properties due to its inhibition of various cell functions, and its response to bacteria is dose-related (15). In addition to its antibacterial properties, benzoyl peroxide can cause keratolysis (5). Studies by Vlahovic et al. (5) and Balic et al. (8) demonstrated the efficacy of a combination of 1% clindamycin and 5% benzoyl peroxide gel (BP) for PK (5,8). Unfortunately, research on the efficacy and safety of topical BP alone, including its appropriate dosage, is currently limited. Thus, the present study aimed to compare the effectiveness and safety of topical 2.5% BP and 5% BP for the treatment of PK and foot malodor.