Benzoyl Peroxide
Benzoyl peroxide
The standard cause of topical intolerance, and — sealed inside silica microcapsules — the second most effective rosacea treatment in this register. The molecule did not change.
The marker is the strength the trials were actually run at. The bar is the span this register has recorded, approved and compounded together. Anything below the marker is a dose nobody has tested; anything above it is an assumption about a dose–response curve nobody has drawn.
The shaded band is the depth this molecule is understood to reach. Anything below it is out of scope, whatever the label says.
Mechanism
An oxidising agent with bactericidal and keratolytic effects. It does not select for bacterial resistance, which is why it is conventionally paired with topical antibiotics. The label of the approved rosacea product states that the precise mechanism in rosacea is unknown.
HOUSE NOTES
- Conventional 5% benzoyl peroxide would not be used on rosacea skin. Microencapsulated 5% produced application-site pain in 2% of subjects and treatment success of 47.4% and 49.2%.
- It is available over the counter at the same concentration. That product is not this product, and substituting it to save money defeats the entire design.
- One of the few antimicrobials that does not select for resistance, which is why it is the standard partner for topical clindamycin.
- It bleaches towels, pillowcases and collars regardless of how it is delivered.
Layering
- Fabric — it bleaches
- Concurrent application with tretinoin
- Topical antibiotics, to limit resistance
- Retinoids, at a different time of day