II. Indication

III. Mechanism

  1. Comedolytic
  2. Kills follicular Bacteria
  3. Resistance cannot develop
    1. Benzoyl Peroxide should be considered in every Acne Vulgaris Management strategy
    2. Reduces Antibiotic Resistance risk in protocols using oral or systemic antibiotics

IV. Preparations

  1. Benzoyl Peroxide alone
    1. Cream 5%, 10%
    2. Gel 2.5%, 5%, 10%
    3. Lotion 5%, 10%
  2. Combination
    1. Benzoyl Peroxide with Clindamycin (Benzaclin)
    2. Benzoyl Peroxide with Erythromycin (Benzamycin)
      1. Gel 50 mg Benzoyl Peroxide and 30 mg Erythromycin
      2. Apply to skin bid, morning & evening
      3. May cause skin dryness, erythema, Pruritus
    3. Benzoyl Peroxide/sulfur (Sulfoxyl Regular or Strong)
      1. Lotion
        1. Benzoyl 5%, Sulfur 2%
        2. Benzoyl 10%, Sulfur 5%
      2. Apply daily to twice daily
      3. May cause skin dryness and Contact Dermatitis

V. Dosing

  1. Start with 2.5% or 5% (less irritating)
  2. Apply to clean skin each day for 3 days
    1. Apply to region of skin (not only over comedones)
  3. Slowly increase strength of application
    1. However 10% preparations are likely to cause more irritation without significant increased benefit
  4. Later increase time left on skin

VI. Advantages

  1. Least expensive Comedolytic ($4 per 30 grams in 2017)

VII. Adverse Effects

  1. May cause skin dryness or irritation
    1. Use water based instead of acetone or Alcohol product
    2. Use Lotion or cream instead of gel
  2. Bleaches hair and skin

VIII. References

  1. (2017) Presc Lett 24(1): 3

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Cost: Medications

benzoyl peroxide (on 8/17/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
BENZOYL PEROXIDE 10% GEL Generic OTC $0.07 per gram
BENZOYL PEROXIDE 10% WASH Generic OTC $0.05 per gram
BENZOYL PEROXIDE 2.5% GEL Generic OTC $0.21 per gram
BENZOYL PEROXIDE 5% GEL Generic OTC $0.05 per gram
BENZOYL PEROXIDE 5% WASH Generic OTC $0.05 per gram
BENZOYL PEROXIDE 6% CLEANSER Generic OTC $0.07 per gram

Ontology: Benzoyl Peroxide (C0005088)

Definition (NCI) A peroxide with antibacterial, irritant, keratolytic, comedolytic, and anti-inflammatory activity. Upon topical application, benzoyl peroxide decomposes to release oxygen which is lethal to the bacteria Proprionibacterium acnes. Due to its irritant effect, benzoyl peroxide increases turnover rate of epithelial cells, thereby peeling the skin and promoting the resolution of comedones. Benzoyl peroxide is used in the treatment of acne vulgaris.
Definition (MSH) A peroxide derivative that has been used topically for BURNS and as a dermatologic agent in the treatment of ACNE and POISON IVY DERMATITIS. It is used also as a bleach in the food industry.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D001585
SnomedCT 91598004, 354053005, 88145002, 332259008, 391829007, 332857001, 332382008
English Benzoyl Peroxide, Benzoyl Superoxide, Dibenzoyl Peroxide, Diphenylglyoxal Superoxide, Peroxide, Benzoyl, Superoxide, Benzoyl, Superoxide, Diphenylglyoxal, Peroxide, Dibenzoyl, Benzoyl peroxide [acne], Benzoyl peroxide [antifungal], Benzoyl peroxide [generic add], benzoyl peroxide, Benzoyl peroxide [generic additions], BENZOYL PEROXIDE, Benzyl peroxide, benzoyl peroxide (medication), Benzoyl Peroxide [Chemical/Ingredient], peroxide benzyl, benzoyl peroxide products, benzyl peroxide, Benzoyl peroxide - chemical, Benzoyl peroxide [acne] (product), Benzoyl peroxide [generic additions] (product), Benzoyl peroxide - chemical (substance), Benzoyl peroxide [antifungal] (product), Benzoyl peroxide, Benzoyl peroxide product, Benzoyl peroxide (substance), Benzoyl peroxide product (product), Benzoyl peroxide -RETIRED-, Benzoyl peroxide [acne] (substance), Benzoyl peroxide [antifungal] (substance), Benzoyl peroxide [generic additions] (substance), Benzoyl peroxide product (substance)
Swedish Bensoylperoxid
Czech benzoylperoxid
Finnish Bentsoyyliperoksidi
Russian PEREKIS' BENZOILA, BENZOILA PEREKIS', БЕНЗОИЛА ПЕРЕКИСЬ, ПЕРЕКИСЬ БЕНЗОИЛА
Spanish peróxido de benzoilo (producto), producto con peróxido de benzoilo (producto), peróxido de benzoilo, peróxido de bencilo (sustancia), peróxido de benzoilo (sustancia), producto con peróxido de benzoilo, peróxido de benzilo, peróxido de bencilo, Peróxido de Benzoílo, peróxido de benzoilo (agregados genéricos) (producto), peróxido de benzoilo (antiacné), peróxido de benzoilo (agregados genéricos), peróxido de benzoílo-RETIRADO- (concepto no activo), peróxido de benzoilo (antifúngico) (producto), peróxido de benzoilo (antifúngico), peróxido de benzoílo-RETIRADO-, peróxido de benzoilo (antiacné) (producto), peróxido de benzoilo (acné) (producto), peróxido de benzoilo (acné), peróxido de benzoilo, producto (producto), peróxido de benzoilo, producto, Superóxido de Benzoilo
French Peroxyde de benzoyle, Peroxyde de dibenzoyle
Polish Nadtlenek benzoilu
Japanese ベンゾイルペルオキシド, 過酸化ジベンゾイル, 過酸化ベンゾイル, 超酸化ベンゾイル, ベンゾイルスーパーオキシド
German Benzoylperoxid, Benzoylsuperoxyd
Italian Perossido di benzoile
Portuguese Peróxido de Benzoil, Superóxido de Benzoil