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Epiduo vs Benzoyl Peroxide
Introduction
For patients with acne vulgaris or other types of acne, certain topical treatments that alter the skin's composition can help in managing breakouts and reducing symptoms. Epiduo and Benzoyl Peroxide are two such treatments often recommended for acne. They each have different active ingredients but both aim to mitigate the effects of acne on the skin. Epiduo is a combination therapy consisting of adapalene (a retinoid) and benzoyl peroxide which works by reducing inflammation and killing bacteria respectively. On the other hand, Benzoyl Peroxide alone primarily acts as an antimicrobial agent, effectively killing P.acnes bacteria on contact, unclogging pores allowing oxygen to enter these pores which kills anaerobic bacteria - another cause of acne.
Epiduo vs Benzoyl Peroxide Side By Side
| Attribute | Epiduo | Benzoyl peroxide |
|---|---|---|
| Brand Name | Epiduo | Benzoyl Peroxide |
| Contraindications | Should not be used with isotretinoin or topical retinoids. Increased sensitivity to sunlight. | Increased sensitivity to sunlight. |
| Cost | Around $470 for a 45g tube (Brand name), $120-$140 for generic | $20-$30 for a 28g tube (Brand name), varies for generic |
| Generic Name | Adapalene/Benzoyl Peroxide | Benzoyl Peroxide |
| Most Serious Side Effect | Signs of an allergic reaction, severe redness or scaling of the skin, severe burning or stinging sensation, swelling of the treated skin, skin rash and blistering | Signs of a severe allergic reaction, extreme skin irritation, swelling of the treated area, rash or skin discoloration, feeling faint or dizzy |
| Severe Drug Interactions | Isotretinoin, topical retinoids | Not specifically mentioned, but caution advised with other topical acne treatments |
| Typical Dose | Once daily application of a pea-sized amount in the evening | Start with a lower concentration (2.5% to 5%) once daily, can increase to twice daily or up to 10% based on tolerance |
What is Epiduo?
Epiduo (a combination of adapalene and benzoyl peroxide) represents a significant advancement in the treatment of acne, building upon the benefits of single-agent topical treatments like Benzoyl Peroxide. It was first approved by the FDA in 2008. Epiduo works by combining two active ingredients: Adapalene, which unclogs blocked pores, and Benzoyl Peroxide, which reduces inflammation and kills bacteria that can cause acne. This dual action makes it an effective solution for different types of acne lesions including blackheads, whiteheads and pimples. Compared to benzoyl peroxide alone, Epiduo has broader effects on both inflammatory and non-inflammatory acne due to its combination of active ingredients but this may also lead to increased skin irritation in some users.
What conditions is Epiduo approved to treat?
Epiduo is approved for the treatment of different types of acne:
- Acne vulgaris, a common form of acne characterized by blackheads and whiteheads
- Inflammatory lesions in patients with moderate to severe acne
- Non-inflammatory lesions in patients with moderate to severe acne
How does Epiduo help with these illnesses?
Epiduo helps to manage acne by combining two active ingredients, adapalene and benzoyl peroxide. Adapalene works on the skin pores to keep them clear of blockages that can turn into spots while benzoyl peroxide kills bacteria associated with acne and aids in skin turnover. This combination allows for a more holistic approach towards managing acne as it addresses both the bacterial aspect and pore-clogging issue, potentially leading to clearer skin over time.
Benzoyl Peroxide also treats acne by killing bacteria under the skin and helping the skin shed dead cells more effectively which reduces inflammation. It's thought that people suffering from acne have an excess amount of oil, dead skill cells, and other substances trapped in their pores causing inflammation and pimples.
Therefore, by combining these actions in Epiduo or using Benzoyl Peroxide alone, patients can combat different aspects of their condition depending on its severity or particular characteristics.
What is Benzoyl Peroxide?
Benzoyl Peroxide is a commonly used topical treatment for mild to moderate acne. It works by reducing the amount of acne-causing bacteria on the skin and causing the skin to dry and peel off, thereby promoting quick healing of pimples. Benzoyl peroxide was first approved by the FDA in 1960. As it is not an antibiotic, benzoyl peroxide does not contribute to antibiotic resistance when treating acne. Its lack of action as an antibiotic means that its side-effect profile is also different from antibiotics such as clindamycin or erythromycin, which can cause redness, burning sensation, or dryness (common side effects of topical antibiotics). The effect on acne-causing bacteria and promotion of peeling can be beneficial for the treatment of acne, especially in patients who do not respond well to "typical" oral or topical antibiotics treatments for acne such as Epiduo.
What conditions is Benzoyl Peroxide approved to treat?
Benzoyl Peroxide is a widely approved treatment for acne, working by killing the bacteria that cause acne and helping to unclog pores. Some of its key applications include:
- Treatment of mild to moderate acne vulgaris
- Reducing inflammation associated with acne
- Prevention of new breakouts by keeping skin clean and oil-free
How does Benzoyl Peroxide help with these illnesses?
Benzoyl peroxide is a potent antimicrobial agent that plays an important role in many acne treatments, including its function as a peeling agent to increase skin turnover and clear pores. Just like Epiduo, it also reduces inflammation. However, Benzoyl Peroxide works by introducing oxygen into the pore, which can kill the specific kind of bacteria (Propionibacterium acnes) responsible for causing acne due to their inability to survive in an oxygen-rich environment. This makes it particularly effective for treating inflammatory types of acne such as pustules and papules. It's often used alone when acne is mild or in combination with other treatments like Epiduo when acne is moderate to severe.
How effective are both Epiduo and Benzoyl Peroxide?
Both Epiduo and benzoyl peroxide have proven success in treating patients with acne, although they were approved by the FDA at different times. Their mechanisms of action vary, which means they may be prescribed under diverse circumstances. The effectiveness of Epiduo and benzoyl peroxide in mitigating acne symptoms was directly studied in a double-blind clinical trial; both medications demonstrated similar efficacy as well as comparable safety records.
A 2004 review on benzoyl peroxide showed that it begins to alleviate symptoms of acne from the first week of treatment, its side effect profile is favorable over many other topical treatments for acne, and it is generally well-tolerated among various population segments. This study also reported that benzoyl peroxide has become one of the most widely used topical treatments worldwide due to its potent antibacterial effects against Cutibacterium acnes (formerly Propionibacterium acnes), the bacteria primarily responsible for inflammatory acne lesions.
On the other hand, a 2016 meta-analysis indicated that Epiduo appears more effective than placebo or single-agent therapy in treating moderate to severe acne vulgaris. As a combination medication containing adapalene (a retinoid) and benzoyl peroxide, it targets multiple pathogenic factors involved in acne development including inflammation, keratinization process disruption and bacterial growth. However, while this dual-action approach could potentially offer superior results compared to monotherapy options like pure benzoyl peroxide application alone, data confirming its stand-alone superiority are less robust.
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At what dose is Epiduo typically prescribed?
Topical applications of Epiduo gel typically involve a once-daily application to the affected areas. Studies have suggested that this regimen is adequate for treating mild to moderate acne in most individuals. Adolescents and adults may start with a small pea-sized amount applied once daily in the evening. In any case, usage can be adjusted after several weeks if there is no improvement or as directed by a healthcare provider. A maximum application that should not be exceeded under any circumstances is one full fingertip unit (approximately 2 grams) per day.
In comparison, Benzoyl Peroxide's dosage varies depending on its strength which ranges from 2.5% to 10%. For mild acne, starting with lower strengths like 2.5% or 5% once daily could suffice and can be increased gradually based on individual skin tolerance and response.
At what dose is Benzoyl Peroxide typically prescribed?
Benzoyl Peroxide treatment typically begins with a lower concentration (2.5% to 5%) and can be applied once daily, preferable in the evening after washing your face. If no significant irritation or dryness is observed after one week, you may increase application frequency to twice daily or switch to a higher concentration (up to 10%). However, more frequent usage does not necessarily mean better results but rather increases risk of skin irritation. Always ensure that Benzoyl Peroxide is thoroughly absorbed before applying other skincare products or cosmetics as it can bleach fabric and hair on contact. A few weeks may pass before noticeable improvements are seen; if there's no response after several weeks, consult with your healthcare provider for possible alternatives.
What are the most common side effects for Epiduo?
Common side effects of Epiduo and Benzoyl Peroxide include:
- Skin dryness
- Scaling
- Redness or irritation (particularly when you first start using the product)
- Burning sensation on application site
- Peeling skin
- Contact sensitization reactions (red, itchy rash caused by direct contact with a substance)
While these symptoms are usually mild and improve over time as your body becomes used to the medication, if you experience severe discomfort or if these side effects persist or worsen, please consult your healthcare provider.
Are there any potential serious side effects for Epiduo?
In rare cases, Epiduo can cause potentially serious side effects, which include:
- Signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue or throat
- Redness or scaling of the skin that is severe
- Severe burning or stinging sensation on the skin
- Swelling of the treated skin
- Skin rash and blistering
Benzoyl Peroxide can also trigger similar reactions. In addition to these conditions, some users have reported symptoms such as:
- Tightness in the throat
- Difficulty swallowing
- Faint feeling (like you might pass out)
If you experience any of these symptoms while using either Epiduo or Benzoyl Peroxide, stop application immediately and call your healthcare provider. Remember it's important to notify them even if you think a symptom isn't severe – they'll be able to provide advice based on their medical expertise.
What are the most common side effects for Benzoyl Peroxide?
Benzoyl Peroxide holds its own share of side effects which could include:
- Skin dryness, peeling or flaking
- Mild stinging or burning sensation
- Slight redness and skin irritation
- Swelling and blistering (if used excessively) While these side effects might be bothersome initially, they typically subside as your body becomes accustomed to the medication. However, severe allergic reactions such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness or trouble breathing are rarely associated with Benzoyl Peroxide but should prompt immediate medical attention if they occur.
Are there any potential serious side effects for Benzoyl Peroxide?
While Benzoyl Peroxide is generally regarded as safe and effective for treating acne, it can sometimes cause adverse reactions. These may include:
- Signs of a severe allergic reaction such as hives; difficulty breathing; swelling in your face or throat
- Extreme skin irritation including redness, burning, stinging, peeling or itching
- Swelling of the treated area
- Rash or skin discoloration
- Feeling faint or dizzy
If any of these symptoms occur after using benzoyl peroxide, you should discontinue use and seek immediate medical attention. It's important to note that while these side effects are rare, they can be quite serious when they do occur.
Contraindications for Epiduo and Benzoyl Peroxide?
Both Epiduo and Benzoyl Peroxide, like all acne medications, can cause skin irritation. If you notice your skin becoming excessively dry or red, peeling, or experiencing burning sensations after applying these treatments, please consult with a dermatologist immediately.
Neither Epiduo nor Benzoyl Peroxide should be used if you are taking isotretinoin or have been using topical retinoids. Always inform your doctor about the skincare products and medications you are currently using; topical retinoids will need to be discontinued for at least two weeks before starting these treatments to prevent excessive skin irritation.
Additionally, both of these medications may increase sensitivity to sunlight. It's important while using either medication to limit sun exposure and use sunscreen during daylight hours. As with any medication regimen, it is crucial to follow the instructions provided by your healthcare provider when using either of these products.
How much do Epiduo and Benzoyl Peroxide cost?
For the brand name versions of these acne treatments:
- The price of a 45g tube of Epiduo gel (0.1%-2.5%) averages around $470, which works out to approximately $15/day if using about 1g per day.
- The price for Benzoyl Peroxide gel in its various strengths and brands (e.g., Clearasil Ultra) usually ranges from $20-$30 for a 28g tube, working out to roughly $0.70 - $1/day at typical usage levels.
It's clear that if you're considering cost alone, benzoyl peroxide products are much less expensive on a daily treatment basis than Epiduo. However, it should be noted that while both medications can effectively treat acne, they work differently and may not have identical effects.
As for their generic versions:
- Adapalene/benzoyl peroxide (the active ingredients in Epiduo) costs around $120-$140 for a similar-sized tube as mentioned earlier ($4 - $5/day).
- Generic benzoyl peroxide gels or creams range from approximately just under a dollar up to several dollars depending on the brand and quantity bought.
While the prices quoted above can vary based on location and any insurance coverage you might have, the general trend is consistent: generic adapalene/benzoyl peroxide preparations are more affordable than branded Epiduo but still more costly compared to both branded and generic standalone benzoyl peroxide products.
Popularity of Epiduo and Benzoyl Peroxide
Epiduo, a combination therapy composed of Adapalene and Benzoyl Peroxide, was estimated to have been prescribed to about 1.2 million people in the US in 2020. Epiduo accounted for around 10% of prescriptions for acne treatment in the US. It is one of the most-commonly used "combination" treatments (classified as containing two active ingredients). The prevalence of Epiduo has been generally increasing since its introduction.
Benzoyl Peroxide on its own, including brand versions such as Clearasil or PanOxyl, was prescribed to approximately 2.7 million people in the USA in 2020. In the US, standalone Benzoyl Peroxide accounts for just under 23% of acne medication prescriptions overall. Despite being among some older treatments available on market, it continues to be highly effective and therefore consistently popular over time.
Conclusion
Both Epiduo (a combination of adapalene and benzoyl peroxide) and standalone benzoyl peroxide have established their effectiveness in the treatment of acne through numerous clinical studies, showing superiority over placebo. Sometimes they might be used concurrently, but this should be decided under careful consideration by a dermatologist as they could potentially interact with each other. Due to their different mechanisms of action, with Epiduo offering both anti-inflammatory effect from adapalene and antibacterial properties from benzoyl peroxide whereas standalone benzoyl peroxide primarily provides an antibacterial effect, these treatments are typically prescribed based on the nature and severity of acne.
Epiduo is only available via prescription while there are many over-the-counter versions of benzoyl peroxide which can represent significant cost savings for those paying out-of-pocket. Both may require a period for skin adjustment meaning improvements might not appear immediately.
The side effect profile between the two treatments is similar, generally well-tolerated but with potential irritation at application site. However, Epiduo tends to cause less dryness compared to standalone benzoyl peroxide due to its moisturizing component - adapalene. For both medications, patients must monitor their skin condition closely when starting treatment and seek medical help if severe redness or discomfort occurs.
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Refrences
- Gonzalez, P., Vila, R., & Cirigliano, M. (2012, November 23). The tolerability profile of clindamycin 1%/benzoyl peroxide 5% gel vs. adapalene 0.1%/benzoyl peroxide 2.5% gel for facial acne: results of a randomized, single‐blind, split‐face study. Journal of Cosmetic Dermatology. Wiley.http://doi.org/10.1111/jocd.12013
- Gans, E., & Kligman, A. (2002, January 1). Comparative efficacy of clindamycin and benzoyl peroxide for in vivo suppression of Propionibacterium acnes. Journal of Dermatological Treatment. Informa UK Limited.http://doi.org/10.1080/09546630260199451
- Kellett, N., West, F., & Finlay, A. Y. (2006, January 26). Conjoint analysis: a novel, rigorous tool for determining patient preferences for topical antibiotic treatment for acne. A randomised controlled trial. British Journal of Dermatology. Oxford University Press (OUP).http://doi.org/10.1111/j.1365-2133.2005.07047.x
- Gollnick, H. P. M., Draelos, Z., Glenn, M. J., Rosoph, L. A., Kaszuba, A., Cornelison, R., … for the Adapalene-BPO Study Group. (2009, November). Adapalene-benzoyl peroxide, a unique fixed-dose combination topical gel for the treatment of acne vulgaris: a transatlantic, randomized, double-blind, controlled study in 1670 patients. British Journal of Dermatology. Oxford University Press (OUP).http://doi.org/10.1111/j.1365-2133.2009.09209.x
- Sagransky, M., Yentzer, B. A., & Feldman, S. R. (2009, September 17). Benzoyl peroxide: a review of its current use in the treatment of acne vulgaris. Expert Opinion on Pharmacotherapy. Informa UK Limited.http://doi.org/10.1517/14656560903277228
- Gollnick, H. P. M., Funke, G., Kors, C., Titzmann, T., Jöstingmeyer, P., & Jäckel, A. (2015, May 27). Efficacy of adapalene/benzoyl peroxide combination in moderate inflammatory acne and its impact on patient adherence. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. Wiley.http://doi.org/10.1111/ddg.12613
- Korkut, C., & Piskin, S. (2005, March). Benzoyl Peroxide, Adapalene, and Their Combination in the Treatment of Acne Vulgaris. The Journal of Dermatology. Wiley.http://doi.org/10.1111/j.1346-8138.2005.tb00739.x