Is 2% salicylic better than 5% or even 2.5% benzoyl peroxide for acne as said here?

Is 2% salicylic acid better than 5% benzoyl peroxide for acne?

In a 12-week study comparing SA with BPO, a 2 percent SA cream was shown to be superior to a 5 percent BPO cream in reducing closed comedones, open comedones, inflammatory lesions and total lesions.

Comments

  • CamelCamel Member
    I would also like to know if anyone has some insight to offer. 
  • PerryPerry Administrator, Professional Chemist
    According to this paper, there was no statistically significant difference.

    But it's possible as 2% is the highest level of SA allowed while BPO is allowed up to 10%. It seems strange they would compare the maximum level of SA versus a lower level of BPO. The funding from the study came from La Roche Possay so it's likely they have a salicylic acid product they were trying to sell.
  • CamelCamel Member
    @Perry, I was curious because I have been prescribed BPO in the past by my dematologist and my skin experienced irritation even at the lower levels. After a couple of months, I switched to SA and found no irritation. So, it's great to know they are comparatively effective. 

    Would you happen to know the efficacy of these ingredients in a cleanser? Is it worth using or is there low deposition?
  • They work differently..BP creates an oxidized environment that p acnes does not do well in. SA breaks up the dirt and oil that clogs the pore. I think it depends on the type of acne you have as to which works for you. Also in Canada BP is only allowed at 5-% without rx. But they are not really easily compared. 
  • PerryPerry Administrator, Professional Chemist
    @Camel - As @Rockstargirl said, they work differently so they will have a different effect on different people's skin. 

    This is an older study but it looks like an SA cleanser would be more effective than a BP cleanser. 


  • CamelCamel Member
    @Perry @Rockstargirl thank you! That was very helpful. 
  • Is there any study that compares 2% salicylic acid cleanser vs leave on product?
  • MicroformulationMicroformulation Member, Professional Chemist
    You can't say that neither is better. It isn't an objective and homogenous response from the patient. Patients respond differently.

    Asking for an objective rating disregards the realities of Clinical practice.
    markfuller@microformulation.com Microformulation.com Microformulation Cosmetic Consulting provides Custom Formulations for both large Commercial accounts as well as smaller entrepreneurs. We can provide Naturally compliant Formulations under the NSF, NPA, Whole Foods and USDA Organic Certifications. BS.Pharm Albany College of Pharmacy, Union University.
  • You have non inflamed acne and inflamed acne. I would fight non inflamed with salicylic and inflamed with benzoyl. Not all acne is the same. The two ingredients are not in competition with each other but used for specific types of acne. If the person has a combination of both then use both ingredients. 
  • You can't say that neither is better. It isn't an objective and homogenous response from the patient. Patients respond differently.

    Asking for an objective rating disregards the realities of Clinical practice.
    My question was not about the response or feelings of patients. My point was if in theory or research one works better than another for acne.
  • You have non inflamed acne and inflamed acne. I would fight non inflamed with salicylic and inflamed with benzoyl. Not all acne is the same. The two ingredients are not in competition with each other but used for specific types of acne. If the person has a combination of both then use both ingredients. 
    Isn't salicylic acid anti inflammation too?
  • PerryPerry Administrator, Professional Chemist
    @Abdullah - your question is a subjective one though. What do you mean by “works better”?  Works better at doing what? What would it mean if one treatment was working better than another? How would you test that in a measurable way? 

    The only way really is to ask patients if they believe their acne is getting better.
  • AbdullahAbdullah Member
    edited March 31
    @Perry thanks 
    Sorry but can you tell me what subjective and objective means here? As English is not my primary language i couldn't understand this part properly.

    By working better i mean better at healing the current acnes and preventing future breakouts in teenagers.

    It would be hard and expensive to me that test these two ingredients against each other but if any other company or research team has tested it, i will accept there research and results. That is what i am doing mostly.
  • PerryPerry Administrator, Professional Chemist
    Objective means you measure some characteristic with a device. For example you measure the length of something with a ruler. Everyone who does it should get the same result (theoretically)

    Subjective means asking people their opinion about some characteristic. For example instead of using a ruler to measure distance you just ask people how long they believe the length of something is.

    when there is a definitive characteristic to measure an objective measurement is better.  But when the characteristic is less defined like whether a treatment works or not, there are only subjective measurements you can take.

    Again you haven’t usefully defined “working”. You’ve just used another vaguely defined word. What does “healing” mean in this context? How would you measure “healing”?

    Look at it this way. You have two treatments. What experiment would you run to determine if one worked better than the other? What specifically would you measure to show one thing worked better than another?
  • Can't count the number and size of acne lesions by fluorescence or CNN analysis?
  • Perry said:
    Objective means you measure some characteristic with a device. For example you measure the length of something with a ruler. Everyone who does it should get the same result (theoretically)

    Subjective means asking people their opinion about some characteristic. For example instead of using a ruler to measure distance you just ask people how long they believe the length of something is.

    when there is a definitive characteristic to measure an objective measurement is better.  But when the characteristic is less defined like whether a treatment works or not, there are only subjective measurements you can take.

    Again you haven’t usefully defined “working”. You’ve just used another vaguely defined word. What does “healing” mean in this context? How would you measure “healing”?

    Look at it this way. You have two treatments. What experiment would you run to determine if one worked better than the other? What specifically would you measure to show one thing worked better than another?
    Thanks for explanation.

    1. "Healing" was the best word i knew to use for the result.
    What result people want to get by using anti acne product if that is not called healing acne?

    2. I don't know what experiment would i run to determine if one worked better that the other. But who knows what experiment did  FDA run so they did know salicylic acid worked better than for example citric acid or benzoic acid so they said salicylic acid is anti acne active and citric or benzoic acid is not?

    If it was like this that they took two products one with salicylic acid and one with citric, and the person who used salicylic acid or the area where salicylic acid was applied had less acne compared to citric acid, then has any company or researcher compared salicylic acid vs BPO the same way?

    If they have compared it directly then how? 
  • PerryPerry Administrator, Professional Chemist
    edited March 31
    @grapefruit22 - yes, those are the kind of objective measurements you could take. But of course there are numerous complications. For example...

    1. How big does something have to be to count as an acne lesion?
    2. How do you compare the size of two differently shaped lesions? They're not all perfect circles. 
    3. What's the expected healing rate of lesions verses an improved rate?
    4. What is a level that anyone would notice?

    and on and on. It just gets complicated.
  • MicroformulationMicroformulation Member, Professional Chemist
    Abdullah said:
    You can't say that neither is better. It isn't an objective and homogenous response from the patient. Patients respond differently.

    Asking for an objective rating disregards the realities of Clinical practice.
    My question was not about the response or feelings of patients. My point was if in theory or research one works better than another for acne.

    The clinical response of patients is by far the best objective measure of efficacy. In my experience, patients will generally rotate through several different products or get augmented with clindamycin.
    markfuller@microformulation.com Microformulation.com Microformulation Cosmetic Consulting provides Custom Formulations for both large Commercial accounts as well as smaller entrepreneurs. We can provide Naturally compliant Formulations under the NSF, NPA, Whole Foods and USDA Organic Certifications. BS.Pharm Albany College of Pharmacy, Union University.
  • emma1985emma1985 Member
    Anecdotally, BP worked much better for me when I had inflammatory hormonal cystic acne. 10% cleared it up pretty well, even though hormonal acne usually has to be treated systemically. I was shocked.
  • emma1985emma1985 Member
    edited April 2
    You have non inflamed acne and inflamed acne. I would fight non inflamed with salicylic and inflamed with benzoyl. Not all acne is the same. The two ingredients are not in competition with each other but used for specific types of acne. If the person has a combination of both then use both ingredients. 
    Totally agree!! The ONLY topical that worked for my inflammatory acne was Benzoyl Peroxide at high concentrations. Even prescription topicals didn't work as well (Clindamycin, Tretinoin.) It's insanely effective!!
  • ngarayeva001ngarayeva001 Member
    edited April 1
    I occasionally get hormonal acne although retinol (and sometimes prescription tretinoin) is part of my daily routine. In such cases I stop retinol and switch to 20% Azelaic Acid for a couple of days. Works like a charm for me [forum member advisory:anecdotal opinion content].
    Tried benzoyl peroxide once and spent a night in an emergency room with severe allergy. To be fair to benzoyl I had no acne next day :)
  • AbdullahAbdullah Member
    I occasionally get hormonal acne although retinol (and sometimes prescription tretinoin) is part of my daily routine. In such cases I stop retinol and switch to 20% Azelaic Acid for a couple of days. Works like a charm for me [forum member advisory:anecdotal opinion content].
    Tried benzoyl peroxide once and spent a night in an emergency room with severe allergy. To be fair to benzoyl I had no acne next day :)
    What percentage BP did you use?
    What was the side effect?
    Did you only use in face or larger body part? 
  • PattsiPattsi Member


    The clinical response of patients is by far the best objective measure of efficacy. In my experience, patients will generally rotate through several different products or get augmented with clindamycin.
    Very true and some rotate through several different clinics. 

    @Abdullah - BP, you need drug manufacturing license and BP gel (made in India) is relatively low priced, it would be difficult or impossible to compete with mid-sized or large pharma.
  • AbdullahAbdullah Member
    Thank you all
  • ngarayeva001ngarayeva001 Member
    edited April 2
    Abdullah said:
    I occasionally get hormonal acne although retinol (and sometimes prescription tretinoin) is part of my daily routine. In such cases I stop retinol and switch to 20% Azelaic Acid for a couple of days. Works like a charm for me [forum member advisory:anecdotal opinion content].
    Tried benzoyl peroxide once and spent a night in an emergency room with severe allergy. To be fair to benzoyl I had no acne next day :)
    What percentage BP did you use?
    What was the side effect?
    Did you only use in face or larger body part? 
    5% which I bought in a pharmacy over the counter.
    My face got swollen to the point where I had to use fingers to open my eyes and when my tongue started swelling I rushed to ER. They gave me steroids but it took 5 days for the swelling to go away.
     I didn’t even applied it on whole face. I used it as a spot treatment on 5 spots.

    The strangest thing is that my skin is an opposite of sensitive. I can use products with pH of 2 without irritation. I can use tretinoin and glycolic acid the same day you name it. It was the first time I had a reaction on something  that I applied on my face.
  • AbdullahAbdullah Member
    Abdullah said:
    I occasionally get hormonal acne although retinol (and sometimes prescription tretinoin) is part of my daily routine. In such cases I stop retinol and switch to 20% Azelaic Acid for a couple of days. Works like a charm for me [forum member advisory:anecdotal opinion content].
    Tried benzoyl peroxide once and spent a night in an emergency room with severe allergy. To be fair to benzoyl I had no acne next day :)
    What percentage BP did you use?
    What was the side effect?
    Did you only use in face or larger body part? 
    5% which I bought in a pharmacy over the counter.
    My face got swollen to the point where I had to use fingers to open my eyes and when my tongue started swelling I rushed to ER. They gave me steroids but it took 5 days for the swelling to go away.
     I didn’t even applied it on whole face. I used it as a spot treatment on 5 spots.

    The strangest thing is that my skin is an opposite of sensitive. I can use products with pH of 2 without irritation. I can use tretinoin and glycolic acid the same day you name it. It was the first time I had a reaction on something  that I applied on my face.
    Interesting. 

    Is it possible that only that specific product or batch had some problem like contamination or something else or you are sure it was BP?

    Long time ago i made lotion with anionic and cationic ingredients together and upon applying to face it was causing tightness of chest and difficulty of breathing. Removing ether cationic or anionic material solved the problem.
  • ngarayeva001ngarayeva001 Member
    edited April 5
    Haven’t tried first two ingredients on my face but it’s probably just benzoyl.

    https://incidecoder.com/products/acnecide-face-gel-spot-treatment

    it’s a great ingredient that is effective for many people. I am probably just allergic. That’s kind of unavoidable. Amongst millions of users there always would be several who are allergic:)
  • AbdullahAbdullah Member
    Haven’t tried first two ingredients on my face but it’s probably just benzoyl.

    https://incidecoder.com/products/acnecide-face-gel-spot-treatment

    it’s a great ingredient that is effective for many people. I am probably just allergic. That’s kind of unavoidable. Amongst millions of users there always would be several who are allergic:)
    Thank
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