Allergic Contact Dermatitis Due to Benzoyl Peroxide From an Unlikely Source
Adelman, Madeline, BS*; Mohammad, Tasneem, MD†; Kerr, Holly, MD†
Dermatitis: May/June 2019 - Volume 30 - Issue 3 - p 230–231
PEARLS & ZEBRAS
Benzoyl peroxide is effective for reducing the number and severity of acne lesions. It has a bactericidal effect on Cutibacterium acnes bacteria associated with acne and does not induce antibiotic resistance. It 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.
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.
Benzoyl peroxide commonly causes initial dryness and sometimes irritation, although the skin develops tolerance after a week or so. A small percentage of people are much more sensitive to it and liable to suffer burning, itching, crusting, and possibly swelling. Applying the lowest concentration and building up as appropriate is most logical. Once tolerance is achieved, increasing the quantity or concentration and gaining tolerance at a higher level may give better subsequent acne clearance. Irritation can also be reduced by avoiding harsh facial cleansers and wearing sunscreen prior to sun exposure.
Other common uses for benzoyl peroxide include:
Tooth whitening systems
The preparation of bleached flour
As a convenient oxidant in organic chemistry
An initiator and catalyst for polyester thermoset resins, as an alternative to the much more hazardous methyl ethyl ketone peroxide
A hardener to start the polymerization process in resins, for instance, PMMA resins can be polymerized with benzoyl peroxide.
Removing ink and dye stains on vinyl dolls and other playscale figures.
In the U.S., the typical concentration for benzoyl peroxide is 2.5% to 10% for both prescription and over-the-counter drug preparations that are used in treatment for acne. Higher concentrations are used for hair bleach and teeth whitening. Benzoyl peroxide, like most peroxides, is a powerful bleaching agent. Contact with fabrics or hair can cause permanent color dampening almost immediately. Even secondary contact can cause bleaching; for example, contact with a towel that has been used to wash off benzoyl peroxide-containing hygiene products. Benzoyl peroxide is also used as a radical initiator to induce chain-growth polymerization reactions, and is the most important among the various organic peroxides used for this purpose.,