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Hydrogen peroxide an alternative to benzoyl peroxide?

I notice Clearasil are selling a "revolutionary" new cream which contains hydrogen peroxide. Anyone have any knowledge or experience of hp v bp?

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When i used just hydrogen peroxide liquid to disinfect a cut or something on my back i noticed it somewhat bleached my back and made it a lot whiter...

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There's been some research on acne involving hydrogen peroxide on pubmed, I think. Try to google it.

Edit: The clearasil cream is a salicylic acid + hydrogen peroxide based cream.

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The reading I've done on it said that Hydrogen Peroxide isn't very effective because it only works on the surface of the skin. It doesn't have the ability to penetrate the pore and get to where the p. acnes bacteria live.

The reason Benzoyl Peroxide works is that the "benzoyl" portion actually pulls the "peroxide" portion down deep into the pores where the bacteria live, and it releases the oxygen there, which kills them.

So, I don't see how Hydrogen Peroxide could be very effective sitting on the surface of the skin when the bacteria actually live in the pores.

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The reading I've done on it said that Hydrogen Peroxide isn't very effective because it only works on the surface of the skin. It doesn't have the ability to penetrate the pore and get to where the p. acnes bacteria live.

The reason Benzoyl Peroxide works is that the "benzoyl" portion actually pulls the "peroxide" portion down deep into the pores where the bacteria live, and it releases the oxygen there, which kills them.

So, I don't see how Hydrogen Peroxide could be very effective sitting on the surface of the skin when the bacteria actually live in the pores.

No, molecularly hydrogen peroxide is smaller than benzoyl peroxide, so there wouldn't be any problem penetrating the pore through the intercellular route.

http://www.medscape.com/viewarticle/452990

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it doesn't have anything to do with molecular size.

It had to do with the hydrogen peroxide just sitting on the skin, and not penetrating through oil to get down into the pore.

That is what the "benzoyl" portion does, it can drag that "peroxide" through your oily pores to where the bacteria live.

Hydrogen peroxide can't do that. It can't penetrate through oil.

p.s. I couldn't get that link to work.

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Efficacy and Safety of Stabilised Hydrogen Peroxide Cream (Crystacide) in Mild-to-Moderate Acne Vulgaris: A Randomised, Controlled Trial Versus Benzoyl Peroxide Gel

from Current Medical Research and Opinion

Posted 05/23/2003

Massimo Milani, Andrea Bigardi, Marco Zavattarelli

Summary and Introduction

Summary

Background: Benzoyl peroxide (BP) is a first-line topical treatment in acne vulgaris (AV). However, its use can cause mild skin irritation and dryness. A new formulation of hydrogen peroxide stabilised (HPS) in monoglycerides cream (Crystacide* 1%), indicated in the topical treatment of superficial skin infections, is now available as an alternative treatment.

Study Aim: To evaluate efficacy and local tolerability of HPS in mild-to-moderate AV in comparison with BP gel.

Methods and Patients: In a randomised, prospective, investigator-masked parallel-group, 8-week trial, 60 patients (24 men, 36 women, mean age 25 ± 6 years) with mild-to-moderate AV, affecting mainly the face, were enrolled in the study, after their informed consent. HPS or BP (PanOxyl†gel 4%) was applied topically twice daily for 8 weeks.

Study Outcomes: The study endpoints were: (1) Reduction in mean inflammatory (IL), non-inflammatory (NIL) and total (TL) acneic lesions in comparison with baseline; (2) Local tolerability assessed evaluating erythema, dryness and burning sensation, using a 0-3 qualitative score (score 0 = poor tolerability; score 3 = very good tolerability).

Results: TL, NIL, and IL were assessed by an investigator unaware of treatment allocation at baseline, and week 8. The tolerability score (TS) was assessed at week 4 and 8. At baseline, the two groups were well matched for the main clinical and demographic characteristics. All patients concluded the trial. At week 0, in the HPS group TL, NIL and IL (mean ± SD) were: 35 ± 8, 20 ± 6 and 16 ± 7. At week 8, HPS reduced TL to 16 ± 7; NIL to 9 ± 3 and IL to 7 ± 3 (p < 0.001). At baseline, TL, NIL and IL, in the BP group, were 32 ± 9, 24 ± 8 and 18 ± 7, respectively. At week 8, BP reduced TL, NIL and IL to 14 ± 9; 7 ± 5 and 7 ± 3 (p < 0.001). In comparison with baseline values, the percentage reductions of IL were 58% and 61% for HPS and BP, respectively (p = n.s.). At the end of the study the TS was 2.9 ± 0.2 in HPS group and 2.4 ± 0.8 in BP group (p < 0.025). Two patients in HPS group (6%) and seven patients (23%) in BP group suffered from mild-to-moderate local erythema.

Conclusions: HPS has shown to be as effective as BP in reducing both inflammatory and non-inflammatory AV lesions in patients with mild-to-moderate disease. In comparison with BP 4% gel, HPS cream shows a better local tolerability profile.

Introduction

Acne vulgaris (AV) is a very common disease affecting 80-85% of teenagers and young adults.[1] The pathology of AV is a complex phenomenon, involving abnormal keratinisation, hormonal functions, immune hypersensitivity and bacterial growth.[2] The disease is limited to pilosebaceous follicles of the head and upper trunk. Propionibacterium acnes (P. acnes) is an obligate anaerobic microorganism which plays a pivotal role in the physiopathology of inflammatory AV.[3] Mild papulopustular acne is generally responsive to topical treatment. Oxidative agents, such as benzoyl peroxide (BP), share a potent bactericidal activity against P. acnes.[4] Topical BP is very effective in the treatment of mild-to-moderate papulopustural AV. As such BP, 2.5-10%, is considered a first-line topical treatment in acne vulgaris (AV).[5] However, its use can cause skin irritation or dryness.[6] Benzoyl peroxide rapidly decomposes into benzoic acid and hydrogen peroxide and it is known that benzoic acid can be responsible for skin irritation and erythema. A new formulation of hydrogen peroxide (H2O2) stabilised in monoglycerides cream (HPS) (Crystacide* 1%), indicated in the topical treatment of superficial skin infections, is now available.[7] This formulation has been shown to be clinically active and well tolerated in the treatment of impetigo. Until now, no clinical data have been available regarding the efficacy and safety profile of this oxidative compound in the treatment of acne.

Study Aim

The primary study aims of this multicentre, randomised, investigator-masked trial were to evaluate efficacy and local tolerability of HPS in mild-to-moderate AV patients, in comparison with BP gel.

*Crystacide is a registered trade name of Mipharm, Italy

†PanOxyl is a registered trade name of Stiefel Laboratories Inc, Coral Gables, Fl, USA

it doesn't have anything to do with molecular size.

It had to do with the hydrogen peroxide just sitting on the skin, and not penetrating through oil to get down into the pore.

That is what the "benzoyl" portion does, it can drag that "peroxide" through your oily pores to where the bacteria live.

Hydrogen peroxide can't do that. It can't penetrate through oil.

p.s. I couldn't get that link to work.

My pharmaceutics text book said the otherwise.

Extracted from Pharmaceutics: The science of dosage form design P.529:

"the pores allow relatively free diffusion of molecules that are not too large."

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I notice Clearasil are selling a "revolutionary" new cream which contains hydrogen peroxide. Anyone have any knowledge or experience of hp v bp?

I posted an article awhile ago that compared HP cream to BP in treating acne. I'll see if I can find it again. I use 5% BP in the evening and an HP cream (from my esthetician) in the a.m. It seems to be working well for me. I don't know what it would do on its own (without the evening BP application) though. I believe that Philosophy makes an HP acne product too. I think the product has gotten decent reviews.

This study actually compares treatment with adapalene + BP against adapalene +HP cream

Skin tolerability and efficacy of combination therapy with hydrogen peroxide stabilized cream and adapalene gel in comparison with benzoyl peroxide cream and adapalene gel in common acne. A randomized, investigator-masked, controlled trial.

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Br J Dermatol. 2004; 151(2):481-4 (ISSN: 0007-0963)

Capizzi R; Landi F; Milani M; Amerio P

Clinica Dermatologica, Policlinico Universitario Agostino Gemelli, Rome, Italy.

BACKGROUND: Combination therapy with antiseptics such as benzoyl peroxide (BP) and topical retinoids is widely used as first-line treatment for acne vulgaris (AV). However, these combinations could have a suboptimal skin tolerability. Recently, a new formulation of hydrogen peroxide (HP) 1% in stabilized cream (Crystacide; Mipharm, Milan, Italy) became available. A previous clinical study has shown that HP cream monotherapy presents a better skin tolerability in comparison with BP in patients with mild AV. OBJECTIVES: To evaluate the tolerability and the efficacy of combination therapy with HP cream and adapalene 0.1% gel in comparison with the combination of BP 4% cream and adapalene 0.1% gel in the treatment of mild to moderate AV. METHODS: In a randomized, investigator-blinded trial, 52 patients (mean +/- SD age 25 +/- 6 years; 19 men and 33 women) with AV were randomly assigned to HP cream and adapalene gel (group HP + A) or to BP cream and adapalene gel (group BP + A), for eight consecutive weeks. Efficacy was assessed by total (TL), inflammatory (IL) and noninflammatory (NL) lesion counts performed at baseline and weeks 4 and 8. Tolerability was assessed by evaluating skin erythema, burning and dryness at weeks 4 and 8. RESULTS: All patients completed the study. At baseline, the mean +/- SD numbers of TL, IL and NL were 44 +/- 9, 25 +/- 7 and 19 +/- 6 in group HP + A and 40 +/- 9, 21 +/- 7 and 19 +/- 9 in group BP + A, respectively. At the end of the treatment period, TL, IL and NL were reduced by 93%, 92% and 95%, respectively, in group HP + A and by 88%, 86% and 90%, respectively, in group BP + A. A significantly (P = 0.0025) greater reduction in NL was observed in group HP + A in comparison with group BP + A. Tolerability was significantly better in group HP + A in comparison with group BP + A (P = 0.02). Skin dryness and burning sensation were more frequent in group BP + A. CONCLUSIONS: The combination of adapalene and HP cream is an effective topical treatment regimen in mild to moderate AV. This combination has shown a better tolerability profile in comparison with the combination of BP and adapalene.

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Efficacy and Safety of Stabilised Hydrogen Peroxide Cream (Crystacide) in Mild-to-Moderate Acne Vulgaris: A Randomised, Controlled Trial Versus Benzoyl Peroxide Gel

from Current Medical Research and Opinion

Posted 05/23/2003

Massimo Milani, Andrea Bigardi, Marco Zavattarelli

Summary and Introduction

Summary

Background: Benzoyl peroxide (BP) is a first-line topical treatment in acne vulgaris (AV). However, its use can cause mild skin irritation and dryness. A new formulation of hydrogen peroxide stabilised (HPS) in monoglycerides cream (Crystacide* 1%), indicated in the topical treatment of superficial skin infections, is now available as an alternative treatment.

Study Aim: To evaluate efficacy and local tolerability of HPS in mild-to-moderate AV in comparison with BP gel.

Methods and Patients: In a randomised, prospective, investigator-masked parallel-group, 8-week trial, 60 patients (24 men, 36 women, mean age 25 ± 6 years) with mild-to-moderate AV, affecting mainly the face, were enrolled in the study, after their informed consent. HPS or BP (PanOxyl⦣8364; gel 4%) was applied topically twice daily for 8 weeks.

Study Outcomes: The study endpoints were: (1) Reduction in mean inflammatory (IL), non-inflammatory (NIL) and total (TL) acneic lesions in comparison with baseline; (2) Local tolerability assessed evaluating erythema, dryness and burning sensation, using a 0-3 qualitative score (score 0 = poor tolerability; score 3 = very good tolerability).

Results: TL, NIL, and IL were assessed by an investigator unaware of treatment allocation at baseline, and week 8. The tolerability score (TS) was assessed at week 4 and 8. At baseline, the two groups were well matched for the main clinical and demographic characteristics. All patients concluded the trial. At week 0, in the HPS group TL, NIL and IL (mean ± SD) were: 35 ± 8, 20 ± 6 and 16 ± 7. At week 8, HPS reduced TL to 16 ± 7; NIL to 9 ± 3 and IL to 7 ± 3 (p < 0.001). At baseline, TL, NIL and IL, in the BP group, were 32 ± 9, 24 ± 8 and 18 ± 7, respectively. At week 8, BP reduced TL, NIL and IL to 14 ± 9; 7 ± 5 and 7 ± 3 (p < 0.001). In comparison with baseline values, the percentage reductions of IL were 58% and 61% for HPS and BP, respectively (p = n.s.). At the end of the study the TS was 2.9 ± 0.2 in HPS group and 2.4 ± 0.8 in BP group (p < 0.025). Two patients in HPS group (6%) and seven patients (23%) in BP group suffered from mild-to-moderate local erythema.

Conclusions: HPS has shown to be as effective as BP in reducing both inflammatory and non-inflammatory AV lesions in patients with mild-to-moderate disease. In comparison with BP 4% gel, HPS cream shows a better local tolerability profile.

Introduction

Acne vulgaris (AV) is a very common disease affecting 80-85% of teenagers and young adults.[1] The pathology of AV is a complex phenomenon, involving abnormal keratinisation, hormonal functions, immune hypersensitivity and bacterial growth.[2] The disease is limited to pilosebaceous follicles of the head and upper trunk. Propionibacterium acnes (P. acnes) is an obligate anaerobic microorganism which plays a pivotal role in the physiopathology of inflammatory AV.[3] Mild papulopustular acne is generally responsive to topical treatment. Oxidative agents, such as benzoyl peroxide (BP), share a potent bactericidal activity against P. acnes.[4] Topical BP is very effective in the treatment of mild-to-moderate papulopustural AV. As such BP, 2.5-10%, is considered a first-line topical treatment in acne vulgaris (AV).[5] However, its use can cause skin irritation or dryness.[6] Benzoyl peroxide rapidly decomposes into benzoic acid and hydrogen peroxide and it is known that benzoic acid can be responsible for skin irritation and erythema. A new formulation of hydrogen peroxide (H2O2) stabilised in monoglycerides cream (HPS) (Crystacide* 1%), indicated in the topical treatment of superficial skin infections, is now available.[7] This formulation has been shown to be clinically active and well tolerated in the treatment of impetigo. Until now, no clinical data have been available regarding the efficacy and safety profile of this oxidative compound in the treatment of acne.

Study Aim

The primary study aims of this multicentre, randomised, investigator-masked trial were to evaluate efficacy and local tolerability of HPS in mild-to-moderate AV patients, in comparison with BP gel.

*Crystacide is a registered trade name of Mipharm, Italy

⦣8364; PanOxyl is a registered trade name of Stiefel Laboratories Inc, Coral Gables, Fl, USA

it doesn't have anything to do with molecular size.

It had to do with the hydrogen peroxide just sitting on the skin, and not penetrating through oil to get down into the pore.

That is what the "benzoyl" portion does, it can drag that "peroxide" through your oily pores to where the bacteria live.

Hydrogen peroxide can't do that. It can't penetrate through oil.

p.s. I couldn't get that link to work.

My pharmaceutics text book said the otherwise.

Extracted from Pharmaceutics: The science of dosage form design P.529:

"the pores allow relatively free diffusion of molecules that are not too large."

That's an interesting study, thanks for posting it. Perhaps they have finally found a way to formulate hydrogen peroxide into a cream that will work. Because traditionally, hydrogen peroxide wasn't effective for acne in it's normal watery formula.

I wonder if there is something in the cream to help it penetrate through facial oil?

Again, it isn't the size of molecule or size of pores that was the problem, it was the fact that hydrogen peroxide alone can't get through oil. So, it sounds like, from the study above, that someone has found a way to stabilize it into a cream. Maybe that helps it penetrate through oil to get down in the pore.

If anyone tries out the cream mentioned in the study, be sure to let us know your results.

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The Clearasil is available OTC but as someone else said it contains both salicylic acid and hydrogen peroxide: http://www.blushingbuyer.co.uk/acatalog/info%5fL013%2ehtml

Judging by the articles hydrogen peroxide is definitely something I'll consider trying. BTW I've travelled a lot in Asia and skin bleach products are very popular because pale skin is considered more desirable. You can even get Nivea skin whitening lotion in Thailand. I wonder if these products contain hydrogen peroxide. Presumably they wouldn't be any good for acne for reasons given by Brandy.

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That's an interesting study, thanks for posting it. Perhaps they have finally found a way to formulate hydrogen peroxide into a cream that will work. Because traditionally, hydrogen peroxide wasn't effective for acne in it's normal watery formula.

I wonder if there is something in the cream to help it penetrate through facial oil?

Again, it isn't the size of molecule or size of pores that was the problem, it was the fact that hydrogen peroxide alone can't get through oil. So, it sounds like, from the study above, that someone has found a way to stabilize it into a cream. Maybe that helps it penetrate through oil to get down in the pore.

If anyone tries out the cream mentioned in the study, be sure to let us know your results.

I think both studies used the same HP cream. They refer to it as a stabilized HP cream - so maybe they solved the problem you mention? It may not be widely available - as it looks like it was formulated and tested just in Italy?

I also wonder about the formulations in the Philosophy HP cream and the clearasil product?

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from what i leant in chemisty back at collage, hydrogen accompanied with an "oxide" does oxidise on the skin, as someone said on this topic, they used it for cuts/wounds, meaning it may attack bad bacteria ect.

i would imagine it works in the same way as Salicylic acid, but with the oxidising part like BP.

however, if it works or not is another story, as big name companies just want to make money by "promising" something will work when it doesnt.

up to you whether you try it or not, good luck:)

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