UK investigators found that roughly 60 percent of people
with mild to moderate acne said they noticed an improvement
after using OTC benzoyl peroxide cream for 18 weeks.
This is the same rate of improvement reported by people who
tried antibiotic pills, antibiotic creams, and creams that
combined an antibiotic with benzoyl peroxide, the researchers
note in The Lancet medical journal.
Benzoyl peroxide "worked just as well in terms of how
people with acne thought their acne had improved, or in terms
of reducing the number of red spots," study author Dr. Hywel C.
Williams told Reuters Health. "Neither were brilliant, but they
were about the same."
Moreover, the benzoyl peroxide used in the current study
was one-twelfth the price of one of the oral antibiotics,
Williams noted, and "more convenient" because it is sold
without a prescription.
Importantly, benzoyl peroxide also sidesteps the growing
problem of bacterial resistance to antibiotics, which can occur
when people take oral antibiotics, added Williams, who is based
at the University of Nottingham.
To investigate how well cheap OTC acne treatments measure
up to prescription antibiotics, Williams and his colleagues
asked 131 people with mild to moderate acne - with at least 15
inflamed lesions and 15 non-inflamed lesions on the face - to
try one of 5 acne treatments for 18 weeks.
The treatments included two types of oral antibiotics
(oxytetracycline and minocycline), benzoyl peroxide lotion,
lotion that combined the antibiotic erythromycin with benzoyl
peroxide, and erythromycin and benzoyl peroxide administered
separately.
To rate improvements, the researchers photographed
participants at the beginning of the study, and asked them to
compare their face after 18 weeks to the picture, as well as
count the number of lesions.
People using topical lotions were more likely to report
skin irritation. Nausea, upset stomach and headache occurred
more often in oral antibiotic-users.
Williams explained that both benzoyl peroxide and
antibiotics likely work by killing a bacteria that can cause
acne.
He added that these findings may surprise some experts. "I
was always brought up to believe that tablets (oral)
antibiotics were much better, but this study suggests not when
they were compared on a level playing field for people with
mild to moderate facial acne," he said.
"It may be different for more severe acne," he added, "but
that goes beyond our study."
One of Williams's co-authors has acted as a consultant for
a company that markets benzoyl peroxide products.
SOURCE: The Lancet, December 18/25, 2004.
