Question:
What is benzoyl peroxide and why is it in nearly all acne treatments?
Answer:
Benzoyl
peroxide is a chemical compound that the FDA has evaluated
and approved as a medication
for the treatment of acne. A key feature of its chemical makeup
is that it is a strong oxidant or oxidizer – in essence
a bleach.
At
the risk of oversimplification, you can think of oxidation as
breaking things down. The rusting of a nail is due to oxidation.
The fading of the paint on your car is oxidation. The clothing
falling apart because of too much bleach is oxidation. And oxidation
is the mechanism by which benzoyl peroxide breaks down the bacteria
that cause acne.
It
is closely related to hydrogen peroxide, the old reliable part
of home emergency supplies everywhere. The usefulness of hydrogen
peroxide is that, when used in the cleaning of a wound, it is
a wonderfully effective antibacterial agent. We’ve all seen
the reassuring bubbling when it’s hard at work.
Similarly,
one of the key features of benzoyl peroxide is that it is one
of the best antibacterials available for use in acne.
•
Deep into the pore. A characteristic of benzoyl peroxide is that
it is able to penetrate deep into the pore, past the plug that
blocks the way for many agents.
•
No Resistance. A major concern when prescription antibiotics are
used is that bacteria (the ‘acne bacteria’ being targeted
and other bacteria exposed to the antibiotic) can develop resistance
to the antibiotic making it more difficult to treat. The nature
of the way that benzoyl peroxide works makes it impossible for
bacteria to develop resistance.
In
addition to its antibacterial benefits, benzoyl peroxide also
penetrates into and helps to break up the plug that blocks the
pore in acne. As the pore becomes unblocked, the oils that have
been backed up behind the plug can now make their way to the surface
in a normal manner.
The
downside of benzoyl peroxide has to do with its oxidative activity
as well. Just as it can damage – and kill – the bacteria
that cause acne, it can also damage the cells of the skin it is
also in contact with.
So,
benzoyl peroxide can cause frustrating side effects, the commonest
of which are a general redness, dryness and flakiness of the skin.
The skin frequently feels irritated and tight.
With
these side effects, it is often tempting to discontinue use –
especially if the acne is not totally out of control. But, doing
so sets you up for a yo-yo effect with alternating periods of
the acne being in control and out-of-control.
The FDA allows use of benzoyl peroxide in non-prescription acne
medication at a concentration anywhere from 2.0% to 10%. Different
products use it at different levels. The popular Proactiv treatment
uses 2.5% benzoyl peroxide, whereas the drugstore product AcneFree
uses it at 3.7%.
What’s
best for you? Well, ideally you’d like to use a concentration
of benzoyl peroxide that is high enough to get good control of
your acne. But, a concentration low enough to avoid significant
side effects. Unfortunately, everybody is different, so there’s
no one product that will be the right balance for everyone.
The
AcneRecovery approach allows each user to adjust a dial, selecting
just the right strength benzoyl peroxide for their own acne situation
– anywhere from 2.0% to 7.0% concentration. For most people,
this solves the frustrations associated with using benzoyl peroxide
medication to treat their acne.Time-Release Benzoyl Peroxide
As
you might guess, the more benzoyl peroxide impacting the skin
at one time, the more likely there is to be irritation and redness.
But,
a recent development in delivery systems makes it possible for
the lotion to release benzoyl peroxide gently over time. The result
is that the impact on the skin happens spread out over time, minimizing
the potential for irritation.
The
high-tech process of making the time-release delivery system adds
significant cost to the ingredient. Most acne treatment systems
thus avoid using it.
However, the AcneRecovery System uses a large amount of time-release
benzoyl peroxide. Fully half of the benzoyl peroxide delivered
in the Treatment Lotion is in the time-release form. Its instant-release
form goes to work immediately, supplemented over ensuing hours
by the time-release form.
Antioxidants
and Benzoyl Peroxide
Here’s
a final observation about using benzoyl peroxide. Antioxidants
are a popular skincare ingredient and are widely recognized
as important to skin health – especially in acne. So, it
would be nice to have antioxidants in your acne product, right?
Well,
the problem is that if you combine an oxidant and an antioxidant
in the same product, you end up with them neutralizing each other.
Sort of like combining hot water and cold water – you end
up with neither. As a result, if you read ingredient labels on
acne products containing benzoyl peroxide, you won’t find
antioxidants included.
A
good solution is to use a benzoyl peroxide product at night –
and then to alternate it with a salicylic acid product, which
can include antioxidants, in the morning.
If
you have a question that you haven't been able to find an answer
to on this site, please send your question about acne to Dr.
Wilkinson.
