Benzoyl peroxide

BPO is a commonly used product for the management of mild to moderate acne. Many teenagers who have acne will purchase overthe- counter products containing BPO, and are likely to have had varying degrees of success with them. BPO works by releasing free radical oxygen within the follicle itself; this has a bactericidal effect thus reducing the bacterial load of P. acnes (Tucker, 2008). BPO is therefore an effective antibacterial product and particularly useful when there are inflammatory lesions as well as non-inflammatory lesions. The impact of BPO is enhanced by the use of topical retinoids; they are often used as a combination therapy.

How to use BPO?
Before starting to use the treatment, patients should be made aware that the product can bleach bedding, clothing and even hair, so care should be taken when using it. The main side effect of BPO products is that they cause reddening and soreness of the skin. This is usually mild and can generally be overcome by starting treatments at a low strength and/or using them on alternate days initially. Gradually over time, the frequency can be increased to once or twice daily. If the lower strengths are tolerated and they are not completely clearing the acne, it is worth moving up to the stronger strengths.

The patient should be instructed to wash their skin with a mild cleanser and pat the skin surface completely dry. The product should then be applied all over the affected area, not just to the lesions. The patient should then wash their hands carefully. Another tip if the skin is particularly sensitive is to leave the product on for just a short period of time initially (washing it off after 15 minutes) and then gradually building up increasing amounts of time as the skin tolerates the product.

BPO may be used as part of a combination regime, usually with retinoids. In these instances, BPO should be used in the morning and the topical retinoid in the evening. It is particularly important for the patient to remember to wash their face prior to using each different topical therapy.