Benzoyl Peroxide Cream Research Articles

Application Characteristics and Patient Preference of Triple-Combination vs Layered Topicals for Acne: Split-Face Study.

Although triple-combination therapies for acne are generally more efficacious than dual-combinations or topical monotherapy, this benefit may be offset by reduced adherence to a complicated treatment regimen. Clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide 3.1% (CAB; Cabtreo®, Ortho Dermatologics) gel is the first triple-combination topical approved for the treatment of acne. By delivering multiple active ingredients as a fixed-dose combination, CAB gel may improve ease of use, which can benefit both treatment adherence and efficacy. The objective of this study was to compare the application characteristics of CAB gel with the layered application of its 3 individual active ingredients. In this split-face study, adults with acne-prone skin (N=25), self-applied CAB gel (0.3 cc) to 1 side of the face and layered benzoyl peroxide cream, adapalene gel, and clindamycin gel (0.1 cc each) on the opposite side. CAB and clindamycin gels were compounded with pyranine, which fluoresces under blue light. Photos taken under blue light were used to assess the uniformity of product application, and participants rated the evenness, speed, and ease of the 2 application regimens, as well as overall preference. Investigator-assessed evenness of application favored CAB gel over layered application in 100% of participants. All participants rated the application of CAB gel as more uniform, easier, and faster. Most (96%) preferred CAB gel for use at home. Fixed-dose CAB gel was applied more evenly than separate application of its 3 active ingredients. By addressing 3 of the main acne pathogenic pathways in a single, easy-to-apply formulation, CAB gel may improve the efficacy of and adherence to acne treatment. J Drugs Dermatol. 2024;23(10):857-861. doi:10.36849/JDD.8430.

Triple-Combination Clindamycin Phosphate 1.2%/Adapalene 0.15%/Benzoyl Peroxide 3.1% Gel for Acne: Clinical Efficacy and Application Characteristics

Background: Triple-combination therapies for acne including an antibiotic, topical retinoid, and benzoyl peroxide (BPO) are among the most effective, with meta-analyses demonstrating greater efficacy with triple-combinations than dual-combinations or topical monotherapy. However, this benefit may be offset by reduced adherence to a complicated treatment regimen. Here, the clinical efficacy of fixed-dose clindamycin phosphate 1.2%/adapalene 0.15%/BPO 3.1% (CAB) gel is reviewed, and the ease of CAB application is compared with the layered application of its individual active ingredients.
 Methods: In a phase 2 (N=741) and two phase 3 (N=183; N=180), double-blind, randomized, 12-week studies, participants aged ≥9 years with moderate-to-severe acne were randomized to receive once-daily CAB or vehicle; the phase 2 study also included treatment arms containing dyad gels (BPO/adapalene; clindamycin phosphate/BPO; clindamycin phosphate/adapalene). Efficacy endpoints included treatment success (percentage of participants achieving ≥2-grade reduction from baseline in Evaluator’s Global Severity Score and clear/almost clear skin) and reductions from baseline in inflammatory (IL) and noninflammatory lesions (NIL). In a split-face study of adults with acne-prone skin (N=25), participant-application of CAB (0.3 cc) was compared to sequential, layered application of benzoyl peroxide cream, adapalene gel, and clindamycin gel (0.1 cc each). IDP-126 and clindamycin gels were compounded with pyranine, which fluoresces under blue light; photos were taken under blue light to assess evenness of product application.
 Results: In all three clinical studies at week 12, half of CAB-treated participants achieved treatment success (range: 49.6%-52.5%), significantly greater than with vehicle (8.1%-24.9%; P<0.01, all) or dyads (phase 2 study only; 27.8%-30.5%; P≤0.001, all). Reductions from baseline in both IL and NIL were also significantly greater for CAB vs vehicle (range, IL: 75.7%-80.1% vs 50.4%-59.6%; NIL: 71.0%-73.3% vs 45.8%-49.0%; P<0.001, all) and dyads (IL: 64.0%-69.2%; NIL: 58.7%-61.1%; P<0.01, all vs IDP-126). In the split-face study, 100% of Investigator and participant assessments of evenness of application favored CAB over the three layered products. In addition, all participants rated CAB as both easier and faster to apply, and most (96%) preferred CAB for use at home.
 Conclusions: Fixed-dose CAB gel applied more evenly than separate application of its three active ingredients, and demonstrated significantly greater efficacy in the treatment of moderate-to-severe acne than dyad gels or vehicle. By addressing three of the main acne pathogenic pathways in a single, easy-to-apply formulation, CAB may improve efficacy of and adherence to acne treatment.
 Funding: Ortho Dermatologics

Epsolay - a benzoyl peroxide cream for rosacea.

Epsolay (Galderma), a 5% benzoyl peroxide cream, has been approved by the FDA for treatment of inflammatory lesions of rosacea in adults.

Long-Term Efficacy and Safety of Benzoyl Peroxide Cream, 5%, Prepared with Microencapsulation in Papulopustular Rosacea: Results from an Extension of Two Phase 3, Vehicle-Controlled Trials

Abstract not available.

Clinical efficacy of 0.5% topical mangosteen extract in nanoparticle loaded gel in treatment of mild-to-moderate acne vulgaris: A 12-week, split-face, double-blinded, randomized, controlled trial.

Acne vulgaris is the most common inflammatory sebaceous gland disorder in young adults. The resistant strains of Propionibacterium acnes (P.acnes) are of increasing concern in the treatment of acne. To evaluate the efficacy of 0.5% topical mangosteen extract in nanoparticle loaded gel (containing alpha-mangostin) compared with 1% clindamycin gel for treatment of mild-to-moderate acne vulgaris. Patients aged 18-40years were enrolled in this double-blinded, split-face, randomized, control study. The 2.5% benzoyl peroxide cream was applied to both sides of the faces once daily for 5 minutes and washed off. Each patient was randomly treated with the mangosteen fruit rind extract on one side and 1% clindamycin on another side of the face twice daily for 12weeks. Treatment efficacies and side effects were evaluated on every follow-up. Twenty-eight patients, 24 female (85.7%), mean ± SD age of 25.14±5.8, with Global Acne Grading system (GAGs) score of 15.43±5.96 were included. Mangosteen fruit rind extract significantly showed significant 66.86% and 67.05% reduction of comedone and inflammatory lesions (P<0.001) after 12-week treatment. The improvement on both treated sides significantly showed since 2weeks after treatment, without statistical difference between two groups. Nonetheless, the mangosteen fruit rind extract revealed significantly better improvement of clinical severity, with no severe side effects. The mangosteen fruit rind extract formation could be a phytopharmaceutical medication for effective treatment of mild and moderate acne vulgaris treatment comparable to 1% clindamycin gel, with no severe side effects.

Cochrane Review: Interventions for cutaneous molluscum contagiosum

AbstractBackgroundMolluscum contagiosum is a common skin infection, caused by a pox virus. The infection will usually resolve within months in people with a normal immune system. Many treatments have been used for molluscum contagiosum but a clear evidence base supporting them is lacking.This is an updated version of the original Cochrane Review published in Issue 2, 2006.ObjectivesTo assess the effects of management strategies (including waiting for natural resolution) for cutaneous, non‐genital molluscum contagiosum in otherwise healthy people.Search strategyIn June 2009 we updated our searches of the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (Issue 2, 2009), MEDLINE, EMBASE, and LILACS. We also searched ongoing trials registers, reference lists, and contacted pharmaceutical companies and experts in the field.Selection criteriaWe investigated randomised controlled trials (RCTs) for the treatment of molluscum contagiosum. We excluded trials on sexually transmitted molluscum contagiosum and in people with lowered immunity (including those with HIV infection).Data collection and analysisTwo authors independently selected studies, assessed methodological quality, and extracted data from selected studies.Main resultsEleven studies, with a total number of 495 participants, examined the effects of topical (9 studies), systemic, and homoeopathic interventions (1 study each). Limited evidence was found for the efficacy of sodium nitrite co‐applied with salicylic acid compared to salicylic acid alone (risk ratio (RR) 3.50, 95% confidence interval (CI) 1.23 to 9.92); for Australian lemon myrtle oil compared to its vehicle, olive oil (RR 17.88, 95% CI 1.13 to 282.72); and for benzoyl peroxide cream compared to tretinoin (RR 2.20, 95% CI 1.01 to 4.79). No statistically significant differences were found for 10 other comparisons, most of which addressed 2 topical treatments.Study limitations included no blinding (four studies), many dropouts (three studies), and no intention‐to‐treat analysis; small study sizes may have led to important differences being missed. None of the evaluated treatment options were associated with serious adverse effects.Authors' conclusionsNo single intervention has been shown to be convincingly effective in the treatment of molluscum contagiosum. The update identified six new studies, most of them reporting on interventions not included in the original version. However, the conclusions of the review did not change.Plain Language SummaryThere is not enough evidence to show that any particular treatment is effective for treating molluscum infection.Molluscum contagiosum, in healthy people, is a self limiting, relatively harmless viral skin infection. It affects mainly children and adolescents. It occurs worldwide but is much more frequent in certain geographic areas with warm climates. Molluscum contagiosum usually presents as single or multiple pimples filled with fluid. People may seek treatment for social and aesthetic reasons and because of concerns about spreading the disease to others. Treatment is intended to speed up the healing process. Eleven studies with 495 patients were included in this review. This review found that many common treatments for molluscum, such as physical destruction, have not been adequately evaluated. Several of the treatments that we studied are not part of daily practice. Limitations of several of these studies were: small numbers of patients, the investigators were not blinded, and patients who did not complete the study (which were numerous in some studies) were not included in the analysis. None of the evaluated treatment options were associated with serious adverse effects. Since most lesions will resolve within months, molluscum contagiosum can be left to heal naturally unless better evidence for the superiority of other treatment options emerges.

Efficacy of Topical Tretinoin, Benzoyl Peroxide and Oral Tetracycline Combination in Acne Vulgaris

This study was done in the outpatient department of Rajshahi Medical College Hospital from January 2004 to December 2005. In this study the efficacy of topical tretinoin, benzoyl peroxide and oral tetracycline was studied in 50 patients. Forty five patients completed the course of treatment and 5 patients were defaulter. Complete remission was seen in 32 (71.11%), marked improvement in 08 (17.78%) and good response in 05 (11.11%) patients. Application of topical tretinoin cream (0.05%) in the evening, benzoyl peroxide cream (5%) in the morning and oral tetracycline (500 mg bd) before meal was found very effective, safe and cheap in the treatment of comedonal, pustular and pustulo-nodular acne vulgaris. doi: 10.3329/taj.v19i1.3161 TAJ 2006; 19(1): 10-12

Laser and other light therapies for the treatment of acne vulgaris: systematic review

Acne is common and can lead to scarring of the skin, as well as to psychological distress and reduced self-esteem. Most topical or oral treatments for acne are inconvenient and have side-effects. Laser and other light therapies have been reported to be convenient, safe and effective in treating acne. To carry out a systematic review of randomized controlled trials of light and laser therapies for acne vulgaris. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycInfo, LILACS, ISI Science Citation Index and Dissertation Abstracts International for relevant published trials. We identified 25 trials (694 patients), 13 of light therapy and 12 of light therapy plus light-activated topical cream (photodynamic therapy, PDT). Overall, the results from trials of light alone were disappointing, but the trials of blue light, blue-red light and infrared radiation were more successful, particularly those using multiple treatments. Red-blue light was more effective than topical 5% benzoyl peroxide cream in the short term. Most trials of PDT showed some benefit, which was greater with multiple treatments, and better for noninflammatory acne lesions. However, the improvements in inflammatory acne lesions were not better than with topical 1% adapalene gel, and the side-effects of therapy were unacceptable to many participants. Some forms of light therapy were of short-term benefit. Patients may find it easier to comply with these treatments, despite the initial discomfort, because of their short duration. However, very few trials compared light therapy with conventional acne treatments, were conducted in patients with severe acne or examined long-term benefits of treatment.

Efficacy and safety of combination therapy of hydrogen peroxide cream and adapalene gel in comparison with benzoyl peroxide cream and adapalene in common acne

Efficacy and safety of combination therapy of hydrogen peroxide cream and adapalene gel in comparison with benzoyl peroxide cream and adapalene in common acne

An open study comparing efficacy of sodium 5% L-ascorbyl-2-phosphate lotion versus 5% benzoylperoxide cream in the treatment of acne vulgaris

An open study comparing efficacy of sodium 5% L-ascorbyl-2-phosphate lotion versus 5% benzoylperoxide cream in the treatment of acne vulgaris

Short-term topical benzoyl peroxide does not reduce cutaneous delayed-type hypersensitivity reactions or epidermal Langerhans cell density

In a pilot study, we investigated the effect of topical benzoyl peroxide on cutaneous delayed-type hypersensitivity and on the number of epidermal Langerhans cells. Healthy volunteers and contact-allergic patients applied a 5% benzoyl peroxide cream to the inside of one forearm once daily for 5 days, and as a control the cream base to the other. Delayed-type hypersensitivity reactions were then tested on both forearms, in five volunteers using the Multitest Merieux and in the patients by patch testing with allergens previously shown to be positive. The Langerhans cells in skin biopsies from both forearms of three healthy volunteers and two contact-allergic patients were identified by the APAAP-method using anti-CD1a antibodies. No statistically significant difference was found in the scores of the Multitest Merieux and in the number of epidermal Langerhans cells between benzoyl peroxide- and cream base- treated skin, nor was the patch test reactivity reduced by the benzoyl peroxide treatment.

Topical Metronidazole Gel

Two percent metronidazole and 5% benzoyl peroxide cream was evaluated in four clinical trials. It could be shown that this test cream was significantly better than 5% benzoyl peroxide jelly alone, and significantly better than a placebo cream. It was also shown that 2% metronidazole and 5% benzoyl peroxide cream was equal to systemic oxytetracycline therapy. The advisability of the combination of metronidazole and benzoyl peroxide was simultaneously discussed.