Exploring Alternatives to Benzoyl Peroxide for Acne Management
Introduction
Benzoyl peroxide (BPO) has long been regarded as the gold standard for treating acne vulgaris, having been approved for this purpose more than 60 years ago. Recently, however, there have been concerns about its safety in light of a study by Valisure LLC that found elevated levels of benzene in some BPO products. Pharmaceutical companies are also exploring alternative treatments for acne. In this article, we will discuss these developments and explore alternatives to BPO for acne management.
The Study by Valisure LLC
In March, Valisure LLC, an independent testing laboratory, tested 66 BPO acne products and found high levels of benzene in some of them. While the study and its methods have been both praised and criticized by clinicians, some patients may be looking for alternatives to BPO, questioning its safety.
Pharmaceutical Companies Exploring Alternatives to BPO
As concerns about the safety of BPO continue to mount, some pharmaceutical companies are exploring alternative treatments for acne. In May, Lindus Health and Acinonyx Bio announced that they will collaborate on a clinical trial investigating Acinonyx Bio’s topical cream, ACX, for the treatment of inflammatory acne. The study will focus on Propionibacterium acnes, which plays a significant role in the development of inflammatory acne. Previous in vitro studies showed that ACX killed P acnes as rapidly as BPO. This trial will enroll patients with moderate to severe inflammatory acne and be conducted as a decentralized clinical trial, allowing patients the flexibility to participate within the comfort of their real-world environments.
Alternatives to BPO for Acne Management
While the study by Valisure LLC is the subject of debate, it has prompted some clinicians to recommend that patients consider alternatives to BPO for acne management. Here are some options:
Topical Retinoids
For most patients, a topical retinoid such as over-the-counter adapalene 0.1% or prescription tretinoin 0.025% is recommended. To minimize irritation, patients should ensure their skin is completely dry before application and start by using the retinoid 2 to 3 times a week. It is also important to advise the use of sunscreen, as retinoids can increase photosensitivity.
Salicylic Acid or Azelaic Acid
For patients who cannot tolerate retinoids or prefer to avoid them, alternatives such as salicylic acid or azelaic acid can be effective. These can also be combined with retinoids for enhanced results if tolerated.
Topical and Oral Antibiotics
Topical and oral antibiotics should not be used alone and are best combined with benzoyl peroxide to prevent resistance. For women with moderate to severe acne, combination oral contraceptives or spironolactone can be considered. Isotretinoin is an option for patients with severe cystic or nodular acne or less severe acne that causes scarring and does not respond to first-line treatments.
Counseling Patients on BPO Use and Storage
For those patients who wish to continue using BPO-containing products, it is important to counsel them on proper storage and discard procedures regarding temperature and expiration dates. According to Christopher Bunick, MD, PhD, PhD, FAAD, an associate professor of dermatology and a physician-scientist at Yale School of Medicine in New Haven, Connecticut, keeping the product refrigerated at all times, renewing the medicine every 3 to 6 months, and avoiding heated storage can slow the decomposition of benzene, although this will not necessarily eliminate all benzene.
Conclusion
While BPO has long been regarded as the gold standard for acne management, concerns about its safety have prompted some patients to seek alternatives. Pharmaceutical companies are also exploring alternative treatments for acne, and some clinicians are recommending that patients consider alternatives to BPO. Counseling patients on proper storage and discard procedures regarding temperature and expiration dates of BPO-containing products is also important. With further investigation and research, new treatments and alternative treatments may become available, providing patients with viable options for managing acne.
Originally Post From https://www.dermatologytimes.com/view/patients-providers-seek-therapeutic-alternatives-to-benzoyl-peroxide
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