The presence of Cutibacterium acnes on the skin of the shoulder after the use of benzoyl peroxide: a placebo-controlled, double-blinded, randomized trial

Abstract

We hypothesized that benzoyl peroxide (BPO) would reduce the presence of Cutibacterium acneson the skin of the shoulder by 50% compared with placebo. Infections after shoulder surgery are most commonly caused by C acnes. Current prophylactic methods do not effectively reduce the bacterial load of this bacterium. However, it seems that BPO may reduce Cacneson the skin of the shoulder. Therefore, this study aimed to investigate the effect of BPO on the presence of C acneson the shoulder skin. A double-blinded, randomized, placebo-controlled trial was performed including healthy participants aged between 40 and 80 years. Thirty participants with C acneson the shoulder skin according to baseline skin swabs were randomized into the BPO or placebo group. Aftergel application 5 times, skin swabs were taken to determine the presence of C acnes. Forty-two participants were screened for the presence of C acnesto include 30 participants with the bacterium. Participants with C acnesat baseline were 7.4 years younger than participants without C acnes (P = .015). One participant in the placebo group dropped out before application because of fear of adverse events. After application, C acnesremained present in 3 of 15participants (20.0%) in the BPO group and in 10 of 14participants (71.4%) in the placebo group, resulting in a 51.4% reduction in the presence of C acnes. Applying BPO 5 times on the shoulder skin effectively reduces C acnes. Consequently, BPO may reduce the risk of postoperative infections.