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BENZOYL PEROXIDE

CAS no.: 94-36-0
EC / List no.: 202-327-6


Benzoyl peroxide is a chemical compound (specifically, an organic peroxide) with structural formula (C6H5−C(=O)O−)2, often abbreviated as (BzO)2. 
In terms of its structure, the molecule can be described as two benzoyl (C6H5−C(=O)−, Bz) groups connected by a peroxide (−O−O−). 
Benzoyl peroxide is a white granular solid with a faint odour of benzaldehyde, poorly soluble in water but soluble in acetone, ethanol, and many other organic solvents. 
Benzoyl peroxide is an oxidizer, which is principally used as in the production of polymers.

As a bleach, Benzoyl peroxide has been used as a medication and a water disinfectant.
In specialized contexts, the name may be abbreviated as BPO.

As a medication, benzoyl peroxide is mostly used to treat acne, either alone or in combination with other treatments. 
Some versions are sold mixed with antibiotics such as clindamycin. 
Benzoyl peroxide is on the WHO List of Essential Medicines,and, in the US, Benzoyl peroxide is available as an over-the-counter and generic medication. 
Benzoyl peroxide is also used in dentistry for teeth whitening.

Benzoyl peroxide is also used in the plastics industry and for bleaching flour, hair, and textiles

Benzoyl peroxide is effective for treating acne lesions. 
Benzoyl peroxide does not induce antibiotic resistance. 
Benzoyl peroxide may be combined with salicylic acid, sulfur, erythromycin or clindamycin (antibiotics), or adapalene (a synthetic retinoid). 
Two common combination drugs include benzoyl peroxide/clindamycin and adapalene/benzoyl peroxide, an unusual formulation considering most retinoids are deactivated by peroxides. 
Combination products such as benzoyl peroxide/clindamycin and benzoyl peroxide/salicylic acid appear to be slightly more effective than benzoyl peroxide alone for the treatment of acne lesions. 
The combination tretinoin/benzoyl peroxide was approved in 2021.

Benzoyl peroxide for acne treatment is typically applied to the affected areas in gel, cream, or liquid, in concentrations of 2.5% increasing through 5.0%, and up to 10%. 

No strong evidence supports the idea that higher concentrations of benzoyl peroxide are more effective than lower concentrations.

Mechanism of action
Classically, benzoyl peroxide is thought to have a three-fold activity in treating acne. 
Benzoyl peroxide is sebostatic, comedolytic, and inhibits growth of Cutibacterium acnes, the main bacterium associated with acne. 
In general, acne vulgaris is a hormone-mediated inflammation of sebaceous glands and hair follicles. 
Hormone changes cause an increase in keratin and sebum production, leading to blocked drainage. 
C. acnes has many lytic enzymes that break down the proteins and lipids in the sebum, leading to an inflammatory response. 
The free-radical reaction of benzoyl peroxide can break down the keratin, therefore unblocking the drainage of sebum (comedolytic). 
Benzoyl peroxide can cause nonspecific peroxidation of C. acnes, making it bactericidal, and it was thought to decrease sebum production, but disagreement exists within the literature on this.

Some evidence suggests that benzoyl peroxide has an anti-inflammatory effect as well.
In micromolar concentrations Benzoyl peroxidet prevents neutrophils from releasing reactive oxygen species, part of the inflammatory response in acne.


Bleaching

Like most peroxides, Benzoyl peroxide is a powerful bleaching agent. 
Benzoyl peroxide has been used for the bleaching of flour, fats, oils, waxes, and cheeses, as well as a stain remover.

Polymerization

Benzoyl peroxide is also used as a radical initiator to induce chain-growth polymerization reactions, such as for polyester and poly(methyl methacrylate) (PMMA) resins and dental cements and restoratives. 
Benzoyl peroxide is the most important among the various organic peroxides used for this purpose, a relatively safe alternative to the much more hazardous methyl ethyl ketone peroxide.
Benzoyl peroxide is also used in rubber curing and as a finishing agent for some acetate yarns.

Benzoyl peroxide is a topical medication used to treat acne breakouts. 
Benzoyl peroxide's found in many different forms, from cleansers, lotions, creams, gels, and toner-like solutions.

In fact, if you've tried blemish-fighting skin care products at point, you've likely already used this ingredient. 
Benzoyl peroxide's a very common ingredient in over-the-counter acne products.

But benzoyl peroxide is not just an OTC treatment. 
Benzoyl peroxide's also available in stronger prescription strengths, and is an active ingredient in many combination prescription acne treatments, like:

BenzaClin, Acanya, Onexton and Duac (all containing benzoyl peroxide and clindamycin)
Benzamycin (benzoyl peroxide and erythromycin)
Epiduo (benzoyl peroxide and adapalene)
Benzoyl peroxide is an antimicrobial, which means Benzoyl peroxide helps reduce the amount of acne-causing bacteria on the skin.

Less bacteria leads to less breakouts. 
Benzoyl peroxide also helps keep the pores clear from blockages. 
Benzoyl peroxide's the most effective over-the-counter acne treatment available.


Benzoyl peroxide is a commonly used topical treatment for mild acne.
benzoyl peroxide is safe for adults and children and can be used in pregnancy.

Benzoyl peroxide has the following properties:

Antiseptic: 
benzoyl peroxide reduces the number of skin surface bacteria (but it does not cause bacterial resistance and in fact can reduce bacterial resistance if this has arisen from antibiotic therapy). 
benzoyl peroxide also reduces the number of yeasts on the skin surface.

Oxidizing agent: 
this makes it keratolytic and comedolytic (it reduces the number of comedones).
Anti-inflammatory action.
Benzoyl peroxide is available as cream, gel, lotion and washes at concentrations of 2.5 %, 5 % and 10 %. 
benzoyl peroxide may be combined with other topical or oral therapy. 
benzoyl peroxide is especially valuable in combination with topical or oral antibiotics as it may reduce the growth of antibiotic-resistant bacteria.

In New Zealand, products containing benzoyl peroxide are available without a prescription. 

They include:

Benoxyl™ 5%, 10% Lotion
Benzac™ AC2.5%, 5%, 10% Gel; Wash 5%
Brevoxyl™ 4% Cream
Oxy™ 5 5% lotion, Oxy™ 10 10% Lotion
PanOxyl™ 2.5%, 5%, 10% Gel, PanOxyl™ AQ 2.5%, 5%, 10% Gel
Benzoyl peroxide is also available on prescription in combination with other active agents.

Epiduo® gel:
benzoyl peroxide with adapalene, a topical retinoid

Duac® Once Daily gel: 
benzoyl peroxide with clindamycin, a topical antibiotic

How to use benzoyl peroxide products
Make sure the skin is clean and dry before applying
Apply a thin smear to areas of skin affected by acne, initially every second night, then build up to once or twice daily as tolerated
benzoyl peroxide can be used on the face as well as the trunk
Be patient: acne responds very slowly to treatment. It may take several months to notice an improvement

Benzoyl peroxide comes in cleansing liquid or bar, lotion, cream, and gel for use on the skin. 
Benzoyl peroxide usually is used one or two times daily. Start with once daily to see how your skin reacts to this medication.
Follow the directions on the package or on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. 
Use benzoyl peroxide exactly as directed. Do not use more or less of it or use it more often than directed by your doctor.

Apply a small amount of the benzoyl peroxide product to one or two small areas you want to treat for 3 days when you begin to use this medication for the first time. 
If no reaction or discomfort occurs, use the product as directed on the package or on your prescription label.

The cleansing liquid and bar are used to wash the affected area as directed.

To use the lotion, cream, or gel, first wash the affected skin areas and gently pat dry with a towel. 
Then apply a small amount of benzoyl Peroxide, rub it in gently.

Avoid anything that may irritate your skin (e.g., abrasive soaps or cleansers, alcohol-containing products, cosmetics or soaps that dry the skin, medicated cosmetics, sunlight, and sunlamps) unless directed otherwise by your doctor.

Benzoyl peroxide may take 4 to 6 weeks to see the effects of this medication. 
If your acne does not improve after this time, call your doctor.

Do not allow medication to get into your eyes, mouth, and nose.

Do not use benzoyl peroxide on children less than 12 years of age without talking to a doctor.

Keep this medication in the container Benzoyl peroxide came in, tightly closed, and out of reach of children. 
Store Benzoyl peroxide at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. 
Instead, the best way to dispose of your medication is through a medicine take-back program. 
Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. 


Benzoyl peroxide is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. 
To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. 

Benzoyl peroxide is an over-the-counter topical medication and is also an FDA-approved prescription medication for the treatment of acne vulgaris. 
Benzoyl peroxide is bactericidal with activity against Cutibacterium acnes (C. acnes) on the skin and within the hair follicles. 
Benzoyl peroxide has mild sebostatic and keratolytic effects and is most effective when used combined with other acne vulgaris therapies. 
In contrast to other topical antibiotics, drug resistance has not appeared to develop with benzoyl peroxide use.

Off-label indications for benzoyl peroxide include:

Inflammatory forms of rosacea 
Folliculitis including gram-negative folliculitis, non-infectious folliculitis, and drug-induced folliculitis (acneiform eruptions)
Pseudo-folliculitis barbae
Progressive macular hypomelanosis 
Decubitus ulcers
Perforating diseases
Pitted keratolysis


Topical benzoyl peroxide exhibits bactericidal effects against Cutibacterium acnes, a key component of acne vulgaris. 
Benzoyl peroxide, once absorbed by the skin, is converted to benzoic acid. 
Approximately 5% of the benzoic acid is systemically absorbed and excreted by the renal system. 
The remaining benzoic acid is metabolized by cysteine in the skin, releasing active free-radical oxygen species resulting in the oxidization of bacterial proteins. 
Improvement of acne vulgaris occurs by reducing lipids, free fatty acids, and P. acnes.

After applying 10% benzoyl peroxide daily for two weeks, the amount of P. acnes in hair follicles decreased by 98%, and the amount of free fatty acids decreased by 50%, which is comparable to results obtained after four weeks of antibiotic therapy.
Topical benzoyl peroxide also has mild sebostatic effects contributing to its keratolytic activity and efficacy in treating comedonal acne.
Benzoyl peroxide effectively treats cutaneous ulcers through stimulation of healthy production of granulation tissue and rapid ingrowth of epithelium.


Benzoyl peroxide is available as both over-the-counter and prescription formulations in concentrations of 2.5%, 5%, and 10%. 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. 
Studies have shown that to treat acne vulgaris, the combination products containing benzoyl peroxide and topical antibiotics or adapalene are more effective than either medication used alone. 
Combination preparations with erythromycin or clindamycin are applied twice daily, whereas combination preparations with adapalene are applied once daily.


Benzoyl peroxide is metabolized in the skin (predominantly in the upper layers of the epidermis) to benzoic acid and free oxygen radicals. 
The former lowers skin pH, the latter disrupts microbial cell membranes. 
Benzoyl peroxide has broad-spectrum antimicrobial activity that persists for 48 h even when conditions for bacterial growth are optimal. 
It has also been shown to be keratoplastic by inhibiting the epidermal metabolism and DNA synthesis.

Benzoyl peroxide has been shown to decrease metabolism of sebaceous gland cells in humans but whether sebum production is actually decreased is controversial. 
Free fatty acids decrease in sebum of human patients treated with benzoyl peroxide, presumably because of its antibacterial effect, as bacterial lipases are responsible for production of free fatty acids. 
Benzoyl peroxide is also believed to have a follicular flushing action.


Benzoyl peroxide is used, in particular, for external treatment of acne. 
About 5% is absorbed (Leachman 2006). To some extent, it is converted to benzoic acid in the skin. 
Simultaneous topical therapy with retinoids increases the absorption. 
Benzoyl peroxide is also used in the food and plastics industries. 
There are insufficient epidemiological data for a risk assessment. 
Despite the broad use, there are no indications of any teratogenic effects.


BP is a lipophilic compound that possesses both mildly comedolytic and potent antibacterial properties. 
In fact, BP is more active against P. acnes than available topical antibiotic preparations. 
In contrast to topical antibiotics, resistance to BP is not observed among P. acnes, likely because BP liberates oxygen which is bactericidal to these mostly obligate anaerobes.

Since the identification of antibiotic-resistant populations of propionibacteria 30 years ago and as the use of antibiotics has become commonplace, recent surveys now document that the majority of P. acnes populations have become resistant to at least one or more antibiotics. 
Fortunately, the use of compounds such as BP can help reduce already extant antibiotic-resistant P. acnes populations and appears to reduce the development of new antibiotic-resistant populations, especially when used in conjunction with topical antibiotics.

BP is highly versatile and can be delivered in a variety of vehicles (cleansers, gels, creams, and lotions) in a broad spectrum of concentrations from 2.5 to 10%. 
Those suffering from chest and back acne may especially benefit from use of BP as a cleanser used in the shower as opposed to a leave-on product which may damage clothing fabrics. 
The use of these products is limited by the drying qualities of BP, its potential for irritancy and occasionally contact sensitization, as well as its propensity to bleach clothing, towels, and bedding. 
Benzoyl peroxide may also render ineffective other topical agents used concomitantly, such as topical tretinoin or topical antibiotics unless the products are effectively stabilized.
Newer technologies and formulations, however, have addressed some of the irritancy potential by combining urea, hyaluronic acid, panthenol, glycerin, or other humectants and emollients with the active ingredient.

Benzoyl peroxide is one of the safest and most effective treatments for inflammatory lesions and is usually used in mild to moderate acne as a first-line therapy. 
Benzoyl peroxide works as an antimicrobial, against P. acnes, although Benzoyl peroxide does not cause bacterial resistance. 
Some studies have shown that Benzoyl peroxide works better than topical tretinoin for inflammatory acne.93,94 Most studies have shown that lower doses work just as well as higher doses and cause less irritation, so there is no need to go higher than 5%.
Benzoyl peroxide has also been shown to improve the effect of antibiotics and decrease the amount of antibiotic resistance, and thus Benzoyl peroxide is recommended to use benzoyl peroxide in combination with topical or oral antibiotics.

Dosage
Recommended dosage is 2.5%–5% gel, lotion, or cream. 
Topical application one to two times a day

Precautions
Can cause skin irritation, including drying and peeling of skin, pruritis, burning, and redness. 
Benzoyl peroxide can bleach hair and clothes.

Of note, benzoyl peroxide can inactivate tretinoin and make Benzoyl peroxide less stable and thus should not be used at the same time. 
Benzoyl peroxide is better to use benzoyl peroxide in the morning and tretinoin at night. 
There are newer formulations of tretinoin (micronized tretinoin gel, tretinoin gel microsphere) and other types of topical retinoids (adapalene) that are not affected by benzoyl peroxide and thus can be used in combination.

Benzoyl peroxide does not have a useful absorption in the ultra-violet or the visible region (Benzoyl peroxide is colourless) that would permit its direct photolysis to free radicals, hence the use of benzoin methyl ether as described above. 
This is despite the fact that the central bond of benzoyl peroxide can be broken by moderate heat alone, in other words, Benzoyl peroxide is in the thermal vibrational range (5§2). 
The energy required can however be transferred from another molecule during a collision, no matter how that energy was obtained. 
For example, Benzoyl peroxide can be the energy of a trapped triplet-state excited molecule, such as described above. 
Thus, using a substance such as benzophenone, which does have a convenient ultra-violet absorption (λmax ~ 250 nm) (but which does not photolyse), irradiation will, in the first instance, produce an excited singlet. 
Ordinarily, this will decay rapidly with a fluorescent emission. 
But, should the hoped-for but very rare collision with a molecule of benzoyl peroxide occur, the energy may be transferred. 
The central bond must break, so that two radicals are formed 


Benzoyl peroxide is a topical antibacterial agent that has been a mainstay in the treatment of acne. 
One advantage to the use of benzoyl peroxide over other antibacterial agents is that bacterial resistance does not develop. 
In addition to its antibacterial effect, benzoyl peroxide may also have antiinflammatory actions by blocking ROS production in neutrophils in a dose-dependent manner. 
Used alone, or in combination with other agents, benzoyl peroxide has remained an important treatment option. 
One study measured bacterial counts from treated individuals, and found that 6% benzoyl peroxide gel is superior in suppressing P. acnes when compared to 1% clindamycin gel.
Multiple studies have shown that, when combined with topical clindamycin, benzoyl peroxide treatment resulted in decreased P. acnes counts and improvement in number of lesions. 
In addition, with the concomitant use of benzoyl peroxide and clindamycin, the number of clindamycin-resistant bacteria did not increase in comparison to clindamycin use alone.

Inflammatory acne is traditionally treated with topical and oral antibiotics. 
Tetracyclines and macrolide antibiotics have been shown to suppress directly the number of P. acnes. 
A major concern in the use of antibiotics is the selection for antibiotic resistance P. acnes. 
Over a 10-year period, the prevalence of skin colonization by propionibacteria resistant to commonly used antiacne antibiotics in patients rose steadily.
Resistance to erythromycin was most common, with the majority of these strains being cross-resistant to clindamycin. 
Tetracycline resistance was encountered less often and did not show a dramatic increase over time. 
A second major concern is the possible link between chronic antibiotic use and the increased risk of developing breast cancer.
Although this association is not clear, there is much concern from the public and further studies are needed at this time to clarify this issue.

In addition to their antibacterial activity, macrolides may also possess some antiinflammatory activity. 
Akamatsu et al. 
demonstrated that the macrolide antibiotic, roxithromycin, inhibits the bacterial lipase and the production of neutrophil chemotactic factor produced by P. acnes.

Another agent that has shown some antibacterial activity is azelaic acid (AZA). 
AZA is a naturally occurring dicarboxylic acid that has been shown to be beneficial in treating acne and has demonstrated significant antibacterial activity. 
One study found a 30-fold decrease in Propionibacterium species, demonstrating similar efficacy to oral tetracycline treatment.
AZA has also been shown to decrease P. acnes protein synthesis and may be related to disruption in bacterial cell transmembrane pH gradient. 
In addition, AZA has a depigmenting effect by inhibiting tyrosinase, an enzyme necessary for melanogenesis, and may be beneficial in patients with the tendency for hyperpigmented scarring.


Benzoyl peroxide (BPO) is non-prescription drug that works to destroy acne-causing bacteria in your pores. 
Benzoyl peroxide works primarily as an exfoliating agent by increasing the turnover of the skin and removes the mixture of sebum and dead skin cells from the pores. 
Benzoyl peroxide comes in 2.5%, 5%, and 10% concentrations that are to be used for those suffering from moderate to severe acne.

"Benzoyl peroxide is a powerful ingredient that is effective against all kinds of acne lesions (blackheads, whiteheads, and big red pimples). 
Benzoyl peroxide is bactericidal, meaning Benzoyl peroxide kills bacteria, rather than simply slowing down their growth. 
Benzoyl peroxide also works very quickly, improving acne as early as five days after starting treatment. 
Benzoyl peroxide's a great first line treatment for acne, but it's also helpful to use in combination with antibiotics.

Benzoyl peroxide, available over the counter and by prescription, has been a mainstay of acne treatment since the 1950s .
This agent has bactericidal and comedolytic properties. 
Benzoyl peroxide is the topical agent most effective against P. acnes, with bacteriostatic activity superior to that of topical antibiotics. 
Benzoyl peroxide also functions as a mild comedolytic agent by increasing epithelial cell turnover with desquamation.


Benzoyl peroxide can be obtained in various concentrations (2.5 to 10 percent), although little evidence exists that efficacy is dependent on the dose. 
This agent comes in water-based or alcohol-based gels. 
The water-based formulations are less drying than the alcohol-based preparations. 
Benzoyl peroxide gels are applied once or twice daily.

Skin irritation is the most common side effect of benzoyl peroxide. 
This effect occurs more often at higher concentrations and tends to decrease with continued use. 
Contact allergy occurs in 1 to 2 percent of patients. 
Patients using benzoyl peroxide formulations for the first time should be instructed to test for allergic dermatitis by applying a small amount of the agent in the antecubital area before using it on the face.

Because benzoyl peroxide is an oxidizing agent, patients should be warned about potential bleaching of clothing and bed linens. 
This problem can be avoided by applying benzoyl peroxide to a clean, dry face in the morning and putting it on the face again at dinner time, if needed.

Benzoyl peroxide (also referred to as BP or BPO) is a topical antibacterial treatment that’s considered one of the most effective acne medications on the market. 
Breakouts occur when oil and dead skin cells clog your pores. 
Benzoyl peroxide penetrates your pores to reach and kill all the P. acnes bacteria (aka acne-causing bacteria) on your skin. 
Benzoyl peroxide is so effective that it was included in some of the world’s first acne treatments and has been considered the gold standard in acne treatment for more than 50 years.

Benzoyl peroxide is such a fascinating ingredient because it delivers oxygen into the pores where acne-causing bacteria thrive. 
This type of bacteria can’t live in an oxygen-rich environment, so Benzoyl peroxide essentially kills it at the source. 
Benzoyl peroxide also helps unclog your pores, and with continued use it helps keep your skin bacteria-free — even after your acne has cleared. 
Finally, benzoyl peroxide works as an anti-inflammatory, reducing the redness and soreness that can accompany a pimple.

If you look at all the prescription meds and over-the-counter acne treatments that include benzoyl peroxide, you’ll see that concentrations vary widely — some formulations include up to 10% BPO. 
Higher concentrations of benzoyl peroxide don’t necessarily make a product more effective at treating acne. 
In fact, studies have shown there’s no significant difference in the results produced from the 2.5%, 5%, or 10% concentrations.

There’s a reason why acne treatments with benzoyl peroxide are available in many prescription and over-the-counter products: 
Benzoyl peroxide can be used over a longer period of time than antibiotics. P. acnes bacteria don’t build up a resistance to Benzoyl peroxide, so you can use benzoyl peroxide as an effective acne treatment for an extended period of time.


Iupac names:
Benzoyl peroxide

benzoyl peroxide

Dibenzoyl peroxide

Synonyms:

202-327-6 
94-36-0 
BENZAC
BENZACLIN
benzoyl benzenecarboperoxoate
Benzoyl peroxide 
Benzoyl peroxide (usp)
Benzoylperoxid 
benzoylperoxide
BPO


 

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