Editing Benzoyl peroxide (section)

== Other uses ==
[[Image:Benzoyl peroxide gel.jpg|thumb|right|Tube of a water-based 5% benzoyl peroxide preparation for the treatment of [[Acne vulgaris|acne]]]]

Benzoyl peroxide is effective for treating [[Acne vulgaris|acne lesions]]. It does not induce [[antibiotic resistance]].<ref name="Simonart2012">{{cite journal | vauthors = Simonart T | s2cid = 12200694 | title = Newer approaches to the treatment of acne vulgaris | journal = American Journal of Clinical Dermatology | volume = 13 | issue = 6 | pages = 357–64 | date = December 2012 | pmid = 22920095 | doi = 10.2165/11632500-000000000-00000 }}</ref><ref name="Seidler2010"/> It may be combined with [[salicylic acid]], [[sulfur]], [[erythromycin]] or [[clindamycin]] ([[antibiotics]]), or [[adapalene]] (a synthetic [[retinoid]]).  Two common [[combination drug]]s include [[benzoyl peroxide/clindamycin]] and [[adapalene/benzoyl peroxide]], [[adapalene]] being a chemically stable retinoid that can be combined with benzoyl peroxide<ref>{{cite book | vauthors = Tolaymat L, Dearborn H, Zito PM | chapter = Adapalene |date=2022 | chapter-url=http://www.ncbi.nlm.nih.gov/books/NBK482509/ | title = StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29494115 |access-date=24 July 2022 }}</ref> unlike [[Tazarotene|tezarotene]] and [[tretinoin]]. 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.<ref name="Seidler2010">{{cite journal | vauthors = Seidler EM, Kimball AB | title = Meta-analysis comparing efficacy of benzoyl peroxide, clindamycin, benzoyl peroxide with salicylic acid, and combination benzoyl peroxide/clindamycin in acne | journal = Journal of the American Academy of Dermatology | volume = 63 | issue = 1 | pages = 52–62 | date = July 2010 | pmid = 20488582 | doi = 10.1016/j.jaad.2009.07.052 }}</ref> The combination [[tretinoin/benzoyl peroxide]] was approved for medical use in the United States 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%.<ref name="Simonart2012"/> No strong evidence supports the idea that higher concentrations of benzoyl peroxide are more effective than lower concentrations.<ref name="Simonart2012"/>

=== Mechanism of action ===
Classically, benzoyl peroxide is thought to have a three-fold activity in treating acne. It is sebostatic, comedolytic, and inhibits growth of  ''[[Cutibacterium acnes]]'', the main [[bacterium]] associated with acne.<ref name="Simonart2012"/><ref name=":0">{{cite journal | vauthors = Cotterill JA | title = Benzoyl peroxide | journal = Acta Dermato-Venereologica. Supplementum | volume = 89 | pages = 57–63 | date = 1 January 1980 | doi = 10.2340/00015555895763 | pmid = 6162349 | doi-access = free }}</ref>  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). It can cause nonspecific peroxidation of ''C. acnes'', making it bactericidal,<ref name=Pl2012/> and it was thought to decrease sebum production, but  disagreement exists within the literature on this.<ref name=":0" /><ref name=":1">{{cite journal | vauthors = Worret WI, Fluhr JW | title = [Acne therapy with topical benzoyl peroxide, antibiotics and azelaic acid] | language = German | journal = Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology | volume = 4 | issue = 4 | pages = 293–300 | date = April 2006 | pmid = 16638058 | doi = 10.1111/j.1610-0387.2006.05931.x | trans-title = Acne therapy with topical benzoyl peroxide, antibiotics and azelaic acid | s2cid = 6924764 }}</ref>

Some evidence suggests that benzoyl peroxide has an anti-inflammatory effect as well. In micromolar concentrations it prevents neutrophils from releasing reactive oxygen species, part of the inflammatory response in acne.<ref name=":1" />

=== Side effects ===
[[File:BenzoperoxideRx.JPG|right|thumb|Skin irritation due to benzoyl peroxide]]
Application of benzoyl peroxide to the skin may result in redness, burning, and irritation. This side effect is dose-dependent.<ref name=WHO2008>{{cite book | title = WHO Model Formulary 2008 | year = 2009 | isbn = 978-92-4-154765-9 | vauthors = ((World Health Organization)) | veditors = Stuart MC, Kouimtzi M, Hill SR | hdl = 10665/44053 | author-link = World Health Organization | publisher = World Health Organization | pages = 307–308 }}</ref><ref name=Ric2015>{{cite book| vauthors = Hamilton R |title=Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition|date=2015|publisher=Jones & Bartlett Learning|isbn=978-1-284-05756-0|page=173}}</ref>

Because of these possible side effects, it is recommended to start with a low concentration and build up as appropriate, as the skin gradually develops [[drug tolerance|tolerance]] to the medication. Skin sensitivity typically resolves after a few weeks of continuous use.<ref name=":1" /><ref name="ReferenceA">{{cite book| veditors = Alldredge BK, Koda-Kimble MA, Young LY |title=Applied Therapeutics: The Clinical Use of Drugs|date=2013|publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins|location=Baltimore|isbn=978-1-60913-713-7|page=949|edition=10th}}</ref> Irritation can also be reduced by avoiding harsh facial cleansers and wearing [[sunscreen]] prior to sun exposure.<ref name="ReferenceA"/>

One in 500 people experience [[hypersensitivity]] to benzoyl peroxide and are liable to experience burning, [[itching]], crusting, and possibly [[Swelling (medical)|swelling]].<ref>{{cite journal | vauthors = Cunliffe WJ, Burke B | title = Benzoyl peroxide: lack of sensitization | journal = Acta Dermato-Venereologica | volume = 62 | issue = 5 | pages = 458–9 | date = 1982 | pmid = 6183909 | doi = 10.2340/0001555562458459 |doi-access=free }}</ref><ref>{{cite web|url=http://www.mayoclinic.org/drugs-supplements/benzoyl-peroxide-topical-route/side-effects/drg-20062425|title=Benzoyl peroxide|publisher=Mayo Clinic|date=1 January 2016|url-status=live|archive-url=https://web.archive.org/web/20160718155333/http://www.mayoclinic.org/drugs-supplements/benzoyl-peroxide-topical-route/side-effects/drg-20062425|archive-date=18 July 2016}}</ref>  About one-third of people experience [[phototoxicity]] under exposure to [[ultraviolet]] (UVB) light.<ref>{{cite journal | vauthors = Jeanmougin M, Pedreiro J, Bouchet J, Civatte J | title = [Phototoxic activity of 5% benzoyl peroxide in man. Use of a new methodology] | journal = Dermatologica | volume = 167 | issue = 1 | pages = 19–23 | date = 1 January 1983 | doi = 10.1159/000249739 | pmid = 6628794 }}</ref>

=== Dosage ===
In the US, the typical concentration for benzoyl peroxide is 2.5% to 10% for both [[Prescription drug|prescription]] and [[over-the-counter drug]] preparations that are used in treatment for acne.<ref>{{Cite web |title=Benzoyl Peroxide: Side Effects, Uses, Dosage, Interactions, Warnings |url=https://www.rxlist.com/benzoyl_peroxide/generic-drug.htm |access-date=2024-08-11 |website=RxList |language=en}}</ref>

===Other medical uses===
Benzoyl peroxide is used in dentistry as a [[tooth whitening]] product.<ref>{{Cite web |title=Some Facts On Teeth Whitening |url=https://worldofdentistry.co.in/some-facts-on-teeth-whitening.php |access-date=2024-11-06 |website=worldofdentistry.co.in}}</ref>