What can I substitute for BPO in my acne regimen PART 3
Recent reports of benzene, a known health hazard, in over the counter (OTC) benzoyl peroxide (BPO) products has many acne patients confused and concerned. I’m here to try to help answer your questions. What is benzene? Is it a really big concern? Should I stop my BPO containing products? What can I use in its place?
Exploring this recent concern left me investigating more and more into this issue, so I will divide this article into a few parts over the next few weeks. This is part three of three. See links to the other parts below.
What is Benzoyl Peroxide (BPO) and how is it used? Benzoyl peroxide is commonly used in OTC and some prescription skin care products. It is used to treat acne both by killing acne bacteria, breaking down dead skin that clogs pores, and by working as an anti-inflammatory agent. Many years ago, almost all BPO containing skin care washes moved from prescriptions to OTC. However, topical prescription leave on treatments often contain BPO as well. BPO is often combined with other oral and topical antibiotics for acne, because studies have shown that using products in combination reduces the likelihood of developing bacterial resistance.
What can I use in place of my BPO containing wash?
Hmm… that’s a good question. The scientific study that triggered this controversy specifically tested Equate, Neutrogena, Clean and Clear, CVS brand, Walgreens brand and Proactiv liquid washes (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10939128/#:~:text=Benzene%20was%20detected%20in%20all,for%20benzene%20for%20drug%20products.) While your particular wash may not be on this list, I think we can safely extrapolate the data to include all BPO containing liquid washes. There are some BPO formulations that have the BPO microencapsulated, which may or may not improve the stability. To my knowledge, none of these formulations were tested. So, as far as OTC BPO containing washes that leaves us with one great choice.
Panoxyl 10% BPO Bar soap. https://panoxyl.com/acne-products/acne-treatment-bar-bpo/ Although this one was not specifically tested, one reference I read indicated that BPO is much more stable in a solid state, up to 98 degrees F. This Panoxyl bar soap has been around a LONG time. I remember learning about it in residency, which admittedly was about 25 years ago now. For those who love BPO it seems like the safest option.
What other active ingredients can I use in place of BPO? Salicylic acid and sulfur.
Salicylic acid is an active ingredient in many acne washes and works to reduce inflammation and break down dead skin that clogs the pores. However, it does NOT kill acne causing bacteria. The most popular right now of these is Cerave Acne Control Cleanser with 2% Salicylic Acid https://www.cerave.com/skincare/cleansers/acne-salicylic-acid-cleanser . Honestly, I am generally underwhelmed by salicylic acid cleansers and rarely recommend them.
Sulfur on the other hand, I recommend ALL THE TIME. Why? Sulfur is “natural” and most people like that. It is antibacterial, anti-inflammatory, and comedolytic (breaks down dead skin that clogs pores). It also kills demodex and controls overgrowth of yeast. For all these reasons, I prescribe it for acne, rosacea, and seborrheic dermatitis. I generally prescribe Rx washes that contain 10% sodium sulfacetamide and 5% sulfur. There are some OTC washes that contain sulfur as well. I have not personally tried any of them.
In part one we learned about benzene, in part three we will discuss what substitutions can be made in an acne regimen if eliminating BPO.
If you know someone who may find this article helpful, please share it with them! Follow us on social media this week, and subscribe to our growing YouTube channel! If you would like to receive these posts in your email inbox, Subscribe to our Site.
