Major Research Findings

Adapalene-benzoyl peroxide topical gel is a combination treatment for mild to moderate acne. A meta-analysis 2 found no statistically significant differences in dryness, scaling, and stinging/burning between subjects with Fitzpatrick skin types I to III and those with Fitzpatrick skin types IV to VI. However, there were statistically significant differences in erythema, with subjects with Fitzpatrick skin types IV to VI more often rated as having "none" than those with Fitzpatrick skin types I to III (P<0.001). This could be due to the difficulty in visualizing erythema in patients with darker skin types, mainly Fitzpatrick skin types VI.

The article 1 describes various acne treatments, including topical benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapy, isotretinoin, and procedural therapies, such as light and laser therapies. While these treatments have benefits for acne management, healthcare providers need to be aware of their potential side effects, including common and serious ones, to ensure safe prescription.

While benzoyl peroxide is an effective acne treatment, there are concerns about rising antibiotic resistance, significant side effects of isotretinoin therapy, and the lack of safe and effective treatments for pregnant women. 3 New treatments, including topical picolinic acid, topical antibiotic dapsone, systemic zinc salts, oral antibiotic lymecycline, new formulations of and synergistic combinations of benzoyl peroxide, photodynamic therapy with topical photosensitizers, and potential acne vaccines, are being developed.

Reasons for Side Effects

Benzoyl peroxide topical medication works by killing Propionibacterium acnes, a bacteria that contributes to acne, and reducing oil production. However, benzoyl peroxide is a strong oxidant and can irritate the skin.

Skin tone differences are related to melanin levels. Patients with Fitzpatrick skin types IV to VI tend to have higher melanin levels, making them more susceptible to irritation from benzoyl peroxide topical medications.

Common Side Effects

Dryness

Benzoyl peroxide topical medication can strip the skin of moisture, leading to dryness. 2

Scaling

Excessive dryness can lead to scaling, where skin flakes off. 2

Stinging/Burning

Benzoyl peroxide topical medication can cause a stinging or burning sensation on the skin. 2

Erythema

Benzoyl peroxide topical medication can cause redness or erythema of the skin. 2

Side Effect Management

Dryness

Applying a moisturizer can help alleviate dryness.

Scaling

If scaling is a concern, consult a dermatologist. They may prescribe appropriate medications or suggest a treatment change.

Stinging/Burning

If you experience stinging or burning, stop using the medication and consult a dermatologist.

Erythema

If erythema is a concern, stop using the medication and consult a dermatologist.

Comparison Between Studies

Similarities

All three studies were randomized controlled trials assessing the safety and efficacy of adapalene-benzoyl peroxide topical gel. 2

Differences

The three studies differed in terms of their inclusion criteria, assessments, and duration. 2

Applying Research Findings to Daily Life

While benzoyl peroxide topical medication is effective for acne, it's important to remember the risk of side effects. 2 , 1

Specifically, patients with Fitzpatrick skin types IV to VI may be more susceptible to side effects such as erythema. 2 Therefore, it's essential to consult a dermatologist before using benzoyl peroxide topical medication to understand proper usage and precautions. 1

Current Limitations in Research

Research on the side effects of benzoyl peroxide topical medication is still limited, particularly regarding side effects in patients with Fitzpatrick skin types IV to VI. 2

Future Directions for Research

Further research is needed on the side effects of benzoyl peroxide topical medication in patients with Fitzpatrick skin types IV to VI. Research and development of new treatment methods to mitigate benzoyl peroxide topical medication side effects are also promising.

Conclusion

Benzoyl peroxide topical medication is an effective treatment for acne, but it's crucial to be aware of the potential side effects. 2 , 1 Consult a dermatologist before using benzoyl peroxide topical medication to understand the correct usage and precautions. 1 Stop using the medication immediately and consult a dermatologist if you experience side effects.