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Acne

The following review suggests that the efficacy of benzoyl peroxide may be enhanced by the presence of Vitamin E and tertiary amines – “Advancement in benzoyl peroxide-based acne treatment: methods to increase both efficacy and tolerability” (J Drugs Dermatol

BACKGROUND: Antibiotic resistance of Propionibacterium acnes (P. acnes) is a growing phenomenon in the wake of widespread use of topical and systemic antibiotics for acne vulgaris. Benzoyl peroxide has a proven track record of safety and efficacy, and can decrease reliance on antibiotics in the treatment of acne. PURPOSE: To review the literature for methods to increase the efficacy and tolerability of benzoyl peroxide (BPO).

METHODS: A PubMed literature search was done using the terms “benzoyl peroxide,” “vehicle,” “mechanism,” and “delivery system.” Relevant papers were reviewed for methods of increasing BPO efficacy and tolerability.

RESULTS: BPO in concentrations of 2.5%, 5% and 10% are equally effective at treating inflammatory acne. However, higher concentrations are associated with more adverse effects. The efficacy of BPO may be enhanced by the presence of Vitamin E and tertiary amines. BPO is also more efficacious if used in combination with topical retinoids than as a monotherapy. Novel vehicles including a microparticle delivery system and those with a hydrophase or urea base increase the tolerability of BPO without sacrificing efficacy.

CONCLUSION: Benzoyl peroxide has a proven track record of safety and efficacy for the treatment of acne. Recent discoveries have provided new methods of increasing the efficacy and tolerability of topical BPO, making it useful as monotherapy for mild acne or as an adjunct in the treatment of moderate to severe acne vulgaris. PMID: 19588642. 2009 Jul;8(7):657-61).

The following clinical paper discusses how vitamins are a natural constituent of human skin and are part of a system of antioxidants that protect the skin from oxidative stress – “Topical vitamins” (J Drugs Dermatol. 2008 Jul;7(7 Suppl):s2-6).

Abstract

Vitamins are a natural constituent of human skin and are part of a system of antioxidants that protect the skin from oxidative stress. There has been an increased interest in the use of natural antioxidants such as vitamins to help restore dermal antioxidant activity. Vitamins A, C, E, and B3 have been shown to have potent antioxidant and anti-inflammatory properties, but to achieve optimal effectiveness products must be delivered in appropriate formulations. Products containing alpha-tocopherol (vitamin E), L-ascorbic acid (vitamin C), retinol (vitamin A), and niacinamide (vitamin B3), are effective for the treatment of photoaging. These compounds have also shown effectiveness in the treatment of inflammatory dermatoses, acne, and pigmentation disorders and wound healing. There is emerging evidence that combinations of vitamins have additive effects that provide enhanced efficacy compared with individual compounds.” PMID: 18681152

We can compound benzoyl peroxide and vitamin E into one topical gel.

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