Acne Treatment
Benzoyl peroxide has been used for acne control since the 1950s in the form of water-based solutions and alcohol-based gels.
Topical Bactericidal Acne Treatments
Topical bactericidals and antimicrobials are among the best acne treatments. These treatments work by attacking the skin bacteria known as Propionibacterium acnes, or P. Acnes, that can contribute to the formation of pimples. Topical bactericidals are available both over the counter and by prescription.
Pros and Cons
Benzoyl peroxide is among the ingredients found in many topical bactericidals and has been used for acne control since the 1950s in the form of water-based solutions and alcohol-based gels. Benzoyl peroxide has been shown to prevent the resistance of P. acnes to bactericidal treatments. For this reason, individuals who are using antibiotics to treat acne will often also use a topical bactericidal containing benzoyl peroxide. In addition to its effects on bacteria, benzoyl peroxide also acts as a mild peeling agent, which is thought to improve acne. One side effect can be skin dryness, but using a water-based acne solution can help. Another downside to using benzoyl peroxide is its tendency to bleach clothing and bedding. For this reason, it is recommended that the treatment be applied to a clean, dry face every morning and evening, as needed.
Some other commonly prescribed topical bactericidals are:
- Azelaic acid, which occurs naturally and can be used to treat non-inflammatory acne and dark spots, but which can cause dryness and lightening of the skin where applied.
- Clindamycin, a topical bactericidal known to be safe and easily tolerated, but which may cause dry and irritated skin.
- Erythromycin, which is thought to be very effective when combined with benzoyl peroxide, but which may also dry and irritate the skin.
- Sodium sulfacetamide, a topical antibiotic that inhibits P. acnes bacteria and opens clogged pores. Some people find the sulfur smell of this treatment to be unpleasant.
Cost
Prescriptions for topical erythromycin are relatively inexpensive, ranging, on average, from $20 to $40, depending on the brand name, dosage and, of course, one's insurance. Azelaic acid prescriptions tend to cost a bit more, ranging, on average, from $50 to $100, also depending on brand, dosage and insurance coverage. According to a study in The Lancet of the various antimicrobial acne treatments, benzoyl peroxide, which can be purchased over the counter, was the most cost-effective.
Effectiveness
The American Academy of Dermatology (AAD) cites the most common use of topical antimicrobials - alone or in combination with other medications - as treatment for mild to moderately severe cases of inflammatory acne.
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Topical bactericidals can be very effective as an acne treatment. Go to the next section to learn about acne products containing topical antibiotics.