No strong evidence supports the idea that higher concentrations of benzoyl peroxide are more effective than lower concentrations. Mechanism of action
Classically, benzoyl peroxide is thought to have a three-fold activity in treating acne. It is sebostatic, comedolytic, and inhibits growth of  Cutibacterium acnes, the main bacterium associated with acne. In general, acne vulgaris is a hormone-mediated inflammation of sebaceous glands and hair follicles. Hormone changes cause an increase in keratin and sebum production, leading to blocked drainage. C. acnes has many lytic enzymes that break down the proteins and lipids in the sebum, leading to an inflammatory response. The free-radical reaction of benzoyl peroxide can break down the keratin, therefore unblocking the drainage of sebum (comedolytic). It can cause nonspecific peroxidation of C. acnes, making it bactericidal, and it was thought to decrease sebum production, but  disagreement exists within the literature on this.Some evidence suggests that benzoyl peroxide has an anti-inflammatory effect as well. In micromolar concentrations it prevents neutrophils from releasing reactive oxygen species, part of the inflammatory response in acne. Side effects
Application of benzoyl peroxide to the skin may result in redness, burning, and irritation. This side effect is dose-dependent.Because of these possible side effects, it is recommended to start with a low concentration and build up as appropriate, as the skin gradually develops tolerance to the medication. Skin sensitivity typically resolves after a few weeks of continuous use.
Hidrocystoma (also known as cystadenoma, a Molls gland cyst, and a sudoriferous cyst) is an adenoma of the sweat glands. : 787 Hidrocystomas are cysts of sweat ducts, usually on the eyelids. : 664  They are not tumours (a similar-sounding lesion called hidroadenoma is a benign tumour). The three types of "sweat" glands are: True sweat glands or eccrine glands, sebaceous glands, which have an oily secretion around hair follicles, and apocrine glands, which have more oily product than eccrine glands and are found on the face, armpit, and groin. Hidrocystomas usually arise from apocrine glands. They are also called cysts of Moll or sudoriferous cysts. A type of hidroadenoma that arises from eccrine glands is uncommon. Other related conditions on the eyelids include chalazion (a granulomatous reaction to sebaceous glands on the eyelid), lacrimal duct cysts (cysts related to tear ducts), and nasolacrimal duct cysts (the nasolacrimal duct drains tears into the nose via a punctum on the lower eyelid). Additional images
See also
Syringoma
Acrospiroma
Seborrheic keratosis
List of cutaneous conditions
List of cutaneous neoplasms associated with systemic syndromes

References


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