Benzoyl Peroxide
Anton C. de Groot in 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).
Basic dermatology in children and adolescents
Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo in Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Topical antibiotics should be used in conjunction with topical retinoids because of their synergistic effects. The antibiotics target P. acnes, limiting the inflammatory component of acne. Effective topical antibiotics include clindamycin, erythromycin, and dapsone. Benzoyl peroxide is a product with antibiotic properties that is used as a topical cream, gel, or wash. Common side effects of benzoyl peroxide include irritation as well as bleaching of hair and fabrics. Resistance to antibiotics can occur with prolonged use of any single agent; therefore, a combination of benzoyl peroxide with clindamycin, erythromycin, or dapsone is often most effective in treating acne and limiting resistance. Sodium sulfacetamide is another topical antibacterial with activity against P. acnes; it is available as a lotion or wash. This is a particularly helpful adjunct to treat acne in the athlete or patient with oily skin in whom the clinician suspects yeast overgrowth.
Acne Vulgaris
Charles Theisler in 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
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.
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.
Emerging drugs for the treatment of acne: a review of phase 2 & 3 trials
Published in Expert Opinion on Emerging Drugs, 2022
Siddharth Bhatt, Rohit Kothari, Durga Madhab Tripathy, Sunmeet Sandhu, Mahsa Babaei, Mohamad Goldust
Benzoyl Peroxide is an organic peroxide derived from coal tar. It is one of the drugs to which no resistance has been detected despite decades of usage. It has antibacterial, oxidative, anti-inflammatory, and keratolytic actions which make it an ideal drug for acne management. Its combination with other drugs is more efficacious than individual use. It helps to prevent resistance to clindamycin when used in combination with it. Combination with retinoids like adapalene provides a synergistic effect. It can cause irritant dermatitis that presents with burning, erythema, peeling, and dryness. This irritation increases with adapalene benzoyl peroxide combination as compared to benzoyl peroxide alone. The chances of true allergy to benzoyl peroxide are rare with an incidence of 0.2 − 1%. It can also bleach the fabric and hair [4].
Related Knowledge Centers
- Acetone
- Benzaldehyde
- Chemical Compound
- Chemical Reaction
- Ethanol
- Hydrogen Peroxide
- Oxidizing Agent
- Organic Peroxides
- Benzoyl Group
- Benzoyl Chloride