Effect of Topical Benzoyl Peroxide on Skin Barrier Integrity Assessed by Transepidermal Water Loss in an Experimental Model
Main Article Content
Abstract
Benzoyl peroxide is a topical agent widely used in the treatment of acne vulgaris; however, its use is associated with cutaneous adverse effects related to impairment of epidermal barrier function. The aim of the present study was to evaluate the effect of topical benzoyl peroxide on skin barrier integrity by measuring transepidermal water loss (TEWL) in an experimental model. An experimental, controlled, and prospective study was conducted comparing a group treated with 5% topical benzoyl peroxide and a control group without active treatment. Transepidermal water loss was measured under controlled environmental conditions before the intervention, during the treatment period, and at the end of the study. The results showed a progressive and statistically significant increase in TEWL in the treated group compared with the control group, demonstrating a time-dependent effect. In addition, the treated group more frequently presented clinical signs of skin irritation, including erythema, dryness, and desquamation, which correlated with increased TEWL. In conclusion, topical application of benzoyl peroxide is associated with a significant impairment of skin barrier function, highlighting the importance of considering therapeutic strategies aimed at preserving epidermal integrity during its clinical use.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Draelos, Z. D. (2007). The effect of benzoyl peroxide on skin barrier function. Journal of Cosmetic Dermatology, 6(1), 27–31.
https://doi.org/10.1111/j.1473-2165.2007.00296.x
II. Fluhr, J. W., Feingold, K. R., & Elias, P. M. (2006). Transepidermal water loss reflects permeability barrier status. Journal of Investigative Dermatology, 126(4), 754–756.
https://doi.org/10.1038/sj.jid.5700199
III. Elias, P. M. (2005). Stratum corneum defensive functions: An integrated view. Journal of Investigative Dermatology, 125(2), 183–200. https://doi.org/10.1111/j.0022-202X.2005.23668.x
IV. Lodén, M. (2012). Role of topical emollients and moisturizers in the treatment of dry skin barrier disorders. American Journal of Clinical Dermatology, 13(3), 151–162.
https://doi.org/10.2165/11597040-000000000-00000
V. Cork, M. J., Danby, S. G., Vasilopoulos, Y., et al. (2009). Epidermal barrier dysfunction in inflammatory skin diseases. Journal of Investigative Dermatology, 129(8), 1892–1908.
https://doi.org/10.1038/jid.2009.133
VI. Del Rosso, J. Q., & Kim, G. (2009). Optimizing use of benzoyl peroxide in acne therapy. Journal of Clinical and Aesthetic Dermatology, 2(10), 48–51.
VII. Proksch, E., Brandner, J. M., & Jensen, J. M. (2008). The skin: An indispensable barrier. Experimental Dermatology, 17(12), 1063–1072. https://doi.org/10.1111/j.1600-0625.2008.00786.x
VIII. Fluhr, J. W., Darlenski, R., & Lachmann, N. (2012). Measurement of skin barrier function: Transepidermal water loss. Dermatologic Clinics, 30(2), 215–224.
https://doi.org/10.1016/j.det.2011.11.002
IX. Gollnick, H., Cunliffe, W., Berson, D., et al. (2003). Management of acne: A report from a Global Alliance. Journal of the American Academy of Dermatology, 49(1), S1–S37.
https://doi.org/10.1067/mjd.2003.618
X. Voegeli, R. (2012). The potential of skin barrier repair formulations. International Journal of Cosmetic Science, 34(1), 1–8.
https://doi.org/10.1111/j.1468-2494.2011.00687.x
XI. Rawlings, A. V., & Harding, C. R. (2004). Moisturization and skin barrier function. Dermatologic Therapy, 17(S1), 43–48.
https://doi.org/10.1111/j.1396-0296.2004.04007.x
XII. Kligman, A. M. (1987). An overview of acne therapy. British Journal of Dermatology, 116(6), 719–722.https://doi.org/10.1111/j.1365-2133.1987.tb05876.x
XIII. Levin, J., & Maibach, H. (2005). The correlation between transepidermal water loss and irritant contact dermatitis. Contact Dermatitis, 52(2), 64–68.https://doi.org/10.1111/j.0105-1873.2005.00505.x
XIV. Darlenski, R., Kazandjieva, J., & Fluhr, J. W. (2011). Skin barrier function: Clinical relevance. Clinics in Dermatology, 30(2), 234–240.
https://doi.org/10.1016/j.clindermatol.2011.08.002
XV. Thiboutot, D., Gollnick, H., Bettoli, V., et al. (2009). New insights into acne pathogenesis. Journal of the American Academy of Dermatology, 60(5), S1–S50. https://doi.org/10.1016/j.jaad.2009.01.019
XVI. Voegeli, R., Rawlings, A. V., & Summers, B. (2007). Stratum corneum integrity and TEWL measurement. Skin Research and Technology, 13(4), 307–314. https://doi.org/10.1111/j.1600-0846.2007.00234.x
XVII. Berardesca, E., Maibach, H., & Wilhelm, K. P. (1995). Skin bioengineering methods in dermatology. Contact Dermatitis, 33(1), 1–9.
https://doi.org/10.1111/j.1600-0536.1995.tb00408.x
XVIII. Verdier-Sévrain, S., & Bonté, F. (2007). Skin hydration: A review on its molecular mechanisms. Journal of Cosmetic Dermatology, 6(2), 75–82. https://doi.org/10.1111/j.1473-2165.2007.00300.x
XIX. Chularojanamontri, L., Tuchinda, P., Kulthanan, K., & Pongparit, K. (2014). Moisturizers and barrier repair in dermatology. Asian Pacific Journal of Allergy and Immunology, 32(4), 257–263.
XX. Kircik, L. H. (2016). The role of barrier repair therapy in acne management. Journal of Drugs in Dermatology, 15(6), 703–707.