Benzoyl Peroxide - StatPearls - NCBI Bookshelf - StatPearls [Internet].

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Federal government websites often end in. Before sharing sensitive information, make sure you're on a federal government site. The site is secure. NCBI Bookshelf. Taraneh Matin ; Marcus B. Authors Taraneh Matin ; Marcus B.

Goodman 1. Benzoyl peroxide is an over-the-counter topical medication and is also an FDA-approved prescription medication for the treatment of acne vulgaris.

It is bactericidal with activity against Cutibacterium acnes on the skin and within the hair follicles. This activity outlines the indications, mechanism of action, safe administration, adverse effects, contraindications, toxicology, and monitoring of the broad array of physiological possibilities when using benzoyl peroxide in the clinical setting. Objectives: Identify the indications for benzoyl peroxide use.

Summarize the mechanism of action of benzoyl peroxide. Describe the most common adverse effects associated with benzoyl peroxide use.

Outline the importance of improving care coordination among the interprofessional team to improve outcomes for patients using benzoyl peroxide. Access free multiple choice questions on this topic. It is bactericidal with activity against Cutibacterium acnes C. Benzoyl peroxide has mild sebostatic and keratolytic effects and is most effective when used combined with other acne vulgaris therapies.

Off-label indications for benzoyl peroxide include [3] [4] [5] [6] [7] :. Topical benzoyl peroxide exhibits bactericidal effects against Cutibacterium acnes, a key component of acne vulgaris. The remaining benzoic acid is metabolized by cysteine in the skin, releasing active free-radical oxygen species resulting in the oxidization of bacterial proteins.

Benzoyl peroxide is available as both over-the-counter and prescription formulations in concentrations of 2. Available preparations include lotions, creams, gels, foams, solutions, cleansing bars, cleansing lotions, cloths, pads, masks, and shaving creams. Each application vehicle has specific instructions for the frequency of use. Cleansing bars and washes are used one to three times a day, whereas mask application is a thin layer that is left on for 15 to 25 minutes once a week.

The most common adverse effect from benzoyl peroxide is its bleaching quality, potentially causing the discoloration of colored fabrics and bleaching of hair. At higher concentrations, topical benzoyl peroxide causes mild dryness, erythema, and scaling. In such instances, the prudent course of action is to discontinue the use of benzoyl peroxide. Patients who present with a known history of hypersensitivity to benzoyl peroxide should not use benzoyl peroxide products.

Patients with hypersensitivity to cinnamon and other benzoic acid derivatives should be cautious in using benzoyl peroxide as cross-reactivity may occur. Benzoyl peroxide is not indicated for use around the eyes, nose, mouth, mucous membranes, and open skin as it may cause severe irritation.

In instances of mucous membrane or ocular contact, thoroughly rinse affected areas with water for a minimum of 15 minutes. Patients should limit their UV exposure and apply sunscreen to decrease the risk of developing phototoxicity and skin irritation. There is little data available supporting the clinical safety and efficacy of benzoyl peroxide when used in children. Because of its minimal systemic absorption, topical benzoyl peroxide is generally regarded as being safe in the pediatric population.

The FDA classifies benzoyl peroxide as pregnancy risk category C. The effects of benzoyl peroxide on reproductive health and fetal health are unknown. However, because of its minimal systemic absorption, topical application of benzoyl peroxide is generally considered safe during pregnancy. There is not much data available on the use of benzoyl peroxide while breastfeeding. Because of its low rate of systemic absorption, minimal risk to the infant is likely, and the topical use of benzoyl peroxide is generally regarded as safe while breastfeeding, as long as its application is not where the infant would have direct contact during breastfeeding or close skin-on-skin contact.

There are no monitoring parameters identified for benzoyl peroxide, and no routine tests are recommended. Development of contact dermatitis to benzoyl peroxide should be monitored, with discontinuation of the medication in patients that develop marked erythema and irritation with its use. Before using benzoyl peroxide, a test area should have a test treatment to monitor for tolerability and sensitivity. Topical benzoyl peroxide is not to be taken by mouth; indications are strictly limited to topical use.

In case of ingestion, patients should callcontact the poison control centeror report to the nearest emergency department. There are no known antidotes for this medication. Despite their individual efficacy in treating mild-to-moderate acne vulgaris, studies have shown that the combined use of antibiotics or retinoids with benzoyl peroxide is more efficacious than either medication used alone.

The combination is believed to be synergistic and has also been shown to prevent the development of antibiotic resistance. The initial disadvantage of combination products is their increased cost and need to be refrigerated to prevent degradation.

This book is distributed under the terms of the Creative Commons Attribution 4. Turn recording back on. Help Accessibility Careers. StatPearls [Internet]. Search term. Affiliations 1 Philadelphia College of Osteopathic Med. Continuing Education Activity Benzoyl peroxide is an over-the-counter topical medication and is also an FDA-approved prescription medication for the treatment of acne vulgaris.

Indications Benzoyl peroxide is an over-the-counter topical medication and is also an FDA-approved prescription medication for the treatment of acne vulgaris.

Folliculitis including gram-negative folliculitis, non-infectious folliculitis, and drug-induced folliculitis acneiform eruptions. Mechanism of Action Topical benzoyl peroxide exhibits bactericidal effects against Cutibacterium acnes, a key component of acne vulgaris. Administration Benzoyl peroxide is available as both over-the-counter and prescription formulations in concentrations of 2.

Adverse Effects The most common adverse effect from benzoyl peroxide is its bleaching quality, potentially causing the discoloration of colored fabrics and bleaching of hair. Contraindications Patients who present with a known history of hypersensitivity to benzoyl peroxide should not use benzoyl peroxide products. Patients should avoid concomitant use of topical hydroquinone with topical benzoyl peroxide as it may result in increased skin irritation and transient staining of the epidermis.

Concomitant use of oral isotretinoin with topical benzoyl peroxide has been reported to result in increased skin irritation and dryness. Patients should avoid concurrent application of topical benzoyl peroxide with topical tretinoin as it results in decreased efficacy of tretinoin. Unlike tretinoin, adapalene is resistant to oxidation by benzoyl peroxide and is an acceptable combination product.

Concomitant use of topical anesthetics with topical benzoyl peroxide reportedly decreases the efficacy of anesthetics. For optimal results, the recommendation is to thoroughly wash the treatment area before applying topical anesthetics. Monitoring There are no monitoring parameters identified for benzoyl peroxide, and no routine tests are recommended.

Toxicity Topical benzoyl peroxide is not to be taken by mouth; indications are strictly limited to topical use.

Review Questions Access free multiple choice questions on this topic. Comment on this article. References 1. Kircik LH. The role of benzoyl peroxide in the new treatment paradigm for acne. J Drugs Dermatol. Zaenglein AL. Acne Vulgaris. N Engl J Med. Leyden JJ. Topical treatment for the inflamed lesion in acne, rosacea, and pseudofolliculitis barbae. A case of progressive macular hypomelanosis successfully treated with benzoyl peroxide plus narrow-band UVB.

J Dermatolog Treat. Med Cutan Ibero Lat Am. Treatment of acquired reactive perforating dermatosis - a systematic review. J Dtsch Dermatol Ges. Adv Skin Wound Care. Benzoyl peroxide: percutaneous penetration and metabolic disposition. J Am Acad Dermatol. Comparative activity of benzoyl peroxide and hexachlorophene.

In vivo studies against propionibacterium acnes in humans. Arch Dermatol. Systematic review of antimicrobial agents used for chronic wounds. Br J Surg. Topical Vehicle Formulations in the Treatment of Acne. Contact dermatitis to topical acne drugs: a review of the literature. Dermatol Ther. Shwereb C, Lowenstein EJ. Delayed type hypersensitivity to benzoyl peroxide. The preadolescent acne microbiome: A prospective, randomized, pilot study investigating characterization and effects of acne therapy.

   


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