Derm: benzoyl peroxide, topical retinoids

Question 1

Indications of benzoyl peroxide?

Answer 1

Acne vulgaris

Question 2

MOA of benzoyl peroxide?

Answer 2

Bactericidal​

Once absorbed into the skin, it is converted into benzoic acid. and free oxygen radicals.
→ These interact with bacterial proteins, which leads to decreased keratin and sebum around follicles.

Can also increase the turnover rate of epithelial cells, leading to skin peeling and breaking down comedones.

Question 3

Adverse effects of benzoyl peroxide?

Answer 3

Allergic skin reactions​ (itching and swelling of the eyes)

Skin irritation (dryness, discomfort, erythema, peeling and blistering)

Increase risk of sunburn

May bleach fabrics and hair.

Question 4

Warnings of benzoyl peroxide?

Answer 4

Avoid in pts with:
- hypersensitivity to the active substance
- broken skin, eyes, mouth, mucous membranes

Question 5

Interactions of benzoyl peroxide?

Answer 5

Benzoyl peroxide is often used in combination with other topical drugs, including topical antibiotics and retinoids.

Can be used on its own.

Question 6

Monitoring of benzoyl peroxide?

Answer 6

Monitor acne and see if there is improvement.

Question 7

Pt education of benzoyl peroxide?

Answer 7

Apply to skin 1-2 times a day preferably after washing with soap and water.

Try to avoid sun exposure i.e. use sunscreen and wear protective clothing.​

Can cause some peeling and redness, but this settles with time.

Question 8

Indications of topical retinoids?

Answer 8

Acne tx

Question 9

Examples of topical retinoids?

Answer 9

adapalene
tretinoin

Question 10

MOA of topical retinoids?

Answer 10

Binds to alpha, beta and gamma retinoic acid receptors (RARs).

Question 11

Adverse effects of topical retinoids?

Answer 11

Skin irritation (dryness, discomfort, erythema, peeling and blistering)

Increase risk of sunburn

Eye irritation.

Question 12

Warnings of topical retinoids?

Answer 12

Avoid in pts with:
- hypersensitivity to the active substance
- pregnancy
- severe acne, perioral dermatitis, rosacea or a personal or family history of non-melanoma skin cancer.

Caution in:
- breastfeeding

Avoid accumulating crewam in the angles of nose and contact with eyes, nostrils, mouth and mucous membranes, eczematous, broken or sunburned skin.

Avoid excess UV light.

Question 13

Interactions of topical retinoids?

Answer 13

Avoid use of topical retinoids with keratolytic agents, abrasive cleaners, and comedogenic or astringent cosmetics.

Question 14

Monitoring of topical retinoids?

Answer 14

Monitor acne and see if there is improvement.

Question 15

Pt education of topical retinoids?

Answer 15

Apply on skin 1-2 times a day, not just on the visible spots but the surrounding area. Discontinue if severe irritation.

If using with benzoyl peroxide, use each 12 hours apart.