INTRODUCTION
Synthesized in 1858 and produced commercially in the United States since 1927, benzoyl peroxide (BPO) is used extensively in industry and health care and is included on the World Health Organization's List of Essential Medicines.1,2,3 BPO is used in the manufacturing of plastics, plexiglass, and Super Glue.1,3 It is a component of dental cements and bleaching agents used for whitening teeth.3 BPO is also added to foods, including flour, cheese, and whey, to whiten their color and reduce the bioburden.1,3 Topical BPO is available as a prescription and over-the-counter (OTC) medication, and is approved by the US Food and Drug Administration (FDA) for the treatment of acne and rosacea.4,5,6
History
BPO use for the treatment of various skin conditions dates to 1905, when Loevenhart examined its therapeutic effects on burns and chronic varicose leg tumors and suggested it could treat various diseases at a reasonable price.7 By the 1920s, BPO was used as a local anesthetic and antiseptic for the treatment of burns and cutaneous ulcers.1 The flammability hazard of BPO was not mentioned in the literature until 1931, when a man being treated with powdered BPO for a poison ivy rash was severely injured following the ignition of bandages on his hands by a lit cigarette, which caused an explosion. The author retracted his recommendation of using powdered BPO as a therapeutic agent, emphasizing its explosive properties, and instead supported an ointment formulation, considered neither flammable nor explosive.1 BPO for the treatment of rosacea was first mentioned in 1950 when Combes and Costello recommended an ointment that consisted of precipitated sulfur and BPO contained in compound chlorhydroxyquinoline, and the effects of the individual constituents were later confirmed in 1961 by Buncke, Alexander, and Harvey.8 In 1958, Fishman hypothesized that a hydrous formulation of the active ingredients would be useful in treating acne.7,9,10 By 1958, Fishman and Gruber developed an aqueous lotion containing 5% BPO and 0.25% chlorhydroxyquinoline that demonstrated efficacy in treating acne.9,10 The product was stocked on a limited basis in pharmacies in New Jersey, New York, and Connecticut; however, the drug was recalled in 1962 due to instability of the BPO creating an impractical shelf life.9,10
History
BPO use for the treatment of various skin conditions dates to 1905, when Loevenhart examined its therapeutic effects on burns and chronic varicose leg tumors and suggested it could treat various diseases at a reasonable price.7 By the 1920s, BPO was used as a local anesthetic and antiseptic for the treatment of burns and cutaneous ulcers.1 The flammability hazard of BPO was not mentioned in the literature until 1931, when a man being treated with powdered BPO for a poison ivy rash was severely injured following the ignition of bandages on his hands by a lit cigarette, which caused an explosion. The author retracted his recommendation of using powdered BPO as a therapeutic agent, emphasizing its explosive properties, and instead supported an ointment formulation, considered neither flammable nor explosive.1 BPO for the treatment of rosacea was first mentioned in 1950 when Combes and Costello recommended an ointment that consisted of precipitated sulfur and BPO contained in compound chlorhydroxyquinoline, and the effects of the individual constituents were later confirmed in 1961 by Buncke, Alexander, and Harvey.8 In 1958, Fishman hypothesized that a hydrous formulation of the active ingredients would be useful in treating acne.7,9,10 By 1958, Fishman and Gruber developed an aqueous lotion containing 5% BPO and 0.25% chlorhydroxyquinoline that demonstrated efficacy in treating acne.9,10 The product was stocked on a limited basis in pharmacies in New Jersey, New York, and Connecticut; however, the drug was recalled in 1962 due to instability of the BPO creating an impractical shelf life.9,10
