However they are popular, with many patients using them as first line treatments. Keratolytics These are usually referred to as comedolytics in acne management. Keratolytics promote shedding of keratolyised epithelial cells on the surface of the skin. They prevent both closure of the pilosebaceous opening and the formation of plugs, which in turn, eases the flow of sebum. This has antibacterial properties and has been proven to reduce surface bacteria a hundred fold.
Bacterial resistance is less likely with benzoyl peroxide than with topical antibiotics.
As benzoyl peroxide is an irritant, it can cause redness, soreness and peeling but this generally improves with continued use. Fair or sensitive skins should always start with 2.5 per cent. If sensitivity occurs, advise to apply for one hour only and wash off. Slowly increase until the patient is able to tolerate normally. This low strength is now a GSL medicine.