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...recent years its use has been increasingly encouraged part of a strategy designed to reduce Propionibacterium acnes (P acnes) resistance to antibiotics. Historically, a major drawback to BPO treatment has been irritation, which may be concentration-dependent or vehicle-dependent. A new BPO microsphere cream formulation has recently been introduced and appears to offer favorable efficacy with a very low potential for irritation. This article presents a series of patients from 2 private dermatologic practices treated with a new BPO microsphere cream formulation both as monotherapy and in combination with other acne drugs.
Introduction
Benzoyl peroxide (BPO) is an important therapy in the management of acne vulgaris. Not only does it offer excellent an-tipropionibacterial activity of its own, (1) but it is now recommended as an adjunct to long-term antibiotic therapy, because it is not associated with bacterial resistance. (2) BPO has inherent anti-inflammatory activity, which may be due to its ability to reduce oxygen free radicals. (2) In a comparison of 5 antimicrobial regimens, (3) it was shown that twice-daily treatment with BPO was both efficacious and cost-effective in the management of facial acne. Topical BPO and BPO/ery-thromycin combinations were similar in efficacy to oral ox-ytetracycline and minocycline and exhibit the added benefit of not being associated with the emergence of Propionibac-terium acnes (P acnes) strains that are less sensitive to antibiotics such as erythromycin, clindamycin, and tetracyclines. The main drawback to BPO therapy has been cutaneous irritation which may be in some cases concentration-dependent, but also vehicle-dependent. (1)
Recently, BPO has been formulated into a unique gradual-release delivery system using Mictosponge [R] technology. Benzoyl peroxide is entrapped in a macroporous polystyrene delivery system and then incorporated into standard vehicles. This technology has been used successfully to improve the tolerability of other topical ingredients such as tretinoin, 5-fluorouracil, and hydroquinone.
In a 14-day cumulative irritancy study in humans, formulations containing BPO 2.5% microsphere or BPO 10.0% microsphere dispersed in...
NOTE: All illustrations and photos
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