There are many different categories of acne medications that are currently available either over-the-counter (OTC) or by prescription.
Let's begin with one of my favorites: benzoyl peroxide (BP). BP is a topical acne medication used for decades (an oldy and a goody!).BP is in many OTC and prescription acne medications.
Why is BP so effective? BP is super effective because it treats two of the main causes of acne:
BP kills the acne causing bacteria (Propionibacteria acnes). P. acnes cannot survive in an oxygen-rich environment. Benzoyl peroxide works by bringing in oxygen to the skin pores, killing the P. acnes. When the number of P. acnes bacteria is reduced, the number of acne breakouts is reduced as well. In particular, those large red, infected appearing acne bumps are reduced.
BP is a 'keratolytic.' This means that it works to break down and exfoliate dead skin cells. BP also helps eliminate oil (scientifically known as "sebum"). By reducing dead skin cells and oil, less blocked pores and acne bumps result. The caveat is that occasionally BP can dry the skin too much leading to redness and irritation. One way to minimize the irritation is by using BP as a FACE WASH! By utilizing BP as a face wash you get the benefits of reduced bacteria and oil, but minimize the irritation and dryness. (A little secret- the Proactiv Renewing Cleanser is just a BP wash!)
Why is BP great for patients with skin of color? BP is a terrific product for quickly reducing new acne outbreaks. This is key for brown skin patients: we need to quickly stop NEW acne, so less brown marks (post-inflammatory hyperpigmentation) results. There is a slight risk with desi patients and BP though—if too much irritation results, this can actually lead to more darkening of the skin! Thus, for most of my brown skin patients I do suggest a BP WASH in a creamy base to protect against irritation.
What are some good products containing BP? —My favorite BP washes include: Pan Oxyl creamy wash and Clean and Clear BP wash. (Of note, BP washes are no longer prescriptions; they are ALL over-the counter) —Topically, a few prescription acne medications that are very effective include:
Epiduo: this contains BP and a gentle type of retinoid called Adaplane.
Acanya or Benzaclin: contain BP and clindamycin
What are some of the side effects of BP? The most common side effect is redness and irritation. BP also bleaches clothes, towels etc. Occasionally, allergic reactions can result from BP use.
Summary: Overall, our goals in treating acne are two fold: treating the active acne and preventing new breakouts. BP accomplishes both of these goals and is a great medication to incorporate into your daily regimen!
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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