Table 1.

RCTs comparing benzoyl peroxide versus vehicle.

Ref	Number of people	Treatment, dose, duration	Results	Comment
	196 people with moderate acne	Benzoyl peroxide 5.5% 4 times daily v benzoyl peroxide plus chlorhydroxyquinolone v benzoyl peroxide plus chlorhydroxyquinolone plus hydrocortisone v vehicle, for 4 weeks	Total lesion count/severity: Benzoyl peroxide significantly reduced total lesion count compared with vehicle (% reduction: 37% with benzoyl peroxide v 6% with vehicle; P = 0.001) Non-inflammatory lesions: No data reported.Inflammatory lesions: No data reported Patient perception of improvement: No data reportedAdverse effects: Suggested that peeling and erythema were “negligible” in all groups
	393 people with moderate acne	Benzoyl peroxide 5% 4 times daily v clindamycin v benzoyl peroxide plus clindamycin v vehicle, for 11 weeks	Total lesion count/severity: No data reportedNon-inflammatory lesions: Benzoyl peroxide significantly reduced number of non-inflammatory lesions compared with vehicle (% change: –30% with benzoyl peroxide v +11% with vehicle; P less than 0.005) Inflammatory lesions: Benzoyl peroxide significantly reduced number of inflammatory lesions compared with vehicle (% reduction: 39% with benzoyl peroxide v 5% with vehicle; P less than 0.002) Patient perception of improvement: No data reportedAdverse effects: More people taking benzoyl peroxide alone or in combination with clindamycin had peeling compared with people taking vehicle (21% with benzoyl peroxide v 22% with benzoyl peroxide plus clindamycin v 15% with vehicle; P value not reported)
	150 people with mild to moderate acne	Benzoyl peroxide 5% v gluconolactone 14% v vehicle for 12 weeks	Total lesion count/severity: Benzoyl peroxide significantly reduced total lesion count from baseline (P less than 0.01) Non-inflammatory lesions: Benzoyl peroxide significantly reduced number of non-inflammatory lesions from baseline (P less than 0.05) Inflammatory lesions: Benzoyl peroxide significantly reduced number of inflammatory lesions from baseline (P less than 0.02) Patient perception of improvement: No data reportedAdverse effects: Benzoyl peroxide 5% significantly increased the proportion of people who had adverse effects, including dryness, scaling, burning, tingling, and redness, compared with vehicle (22/75 [29%] with benzoyl peroxide v 5/75 [7%] with vehicle; P = 0.05)	When assessing benefits, did not directly compare benzoyl peroxide and vehicle, but assessed within-group differences from baseline in each group
	77 people with mild to moderate acne	Benzoyl peroxide 5% v isotretinoin v vehicle, for 12 weeks	Total lesion count/severity: Benzoyl peroxide significantly reduced severity scores compared with vehicle (Leeds score where 0 = no acne and 10 = severest acne: 0 with benzoyl peroxide v 1 with vehicle; P less than 0.05)Non-inflammatory lesions: Benzoyl peroxide significantly reduced number of non-inflammatory lesions compared with vehicle (mean % change –52% with benzoyl peroxide v +6% with vehicle; P = 0.01) Inflammatory lesions: Benzoyl peroxide significantly reduced number of inflammatory lesions compared with vehicle (mean % change –52% with benzoyl peroxide v +9 with vehicle; P = 0.01) Patient perception of improvement: No data reportedAdverse effects: Benzoyl peroxide associated with erythema, dryness, soreness, and burning; 1 person taking benzoyl peroxide withdrew because of adverse effects
	59 people with mild to moderate acne	Benzoyl peroxide 20% v vehicle, for 12 weeks	Total lesion count/severity: Benzoyl peroxide significantly reduced total number of lesions after 12 weeks' treatment compared with vehicle (proportion of people with “good” [51–75% reduction] or “excellent” [76–100% reduction] response: 19/26 [73%] with benzoyl peroxide v 10/25 [40%] with vehicle; P less than 0.05) Non-inflammatory lesions: No data reportedInflammatory lesions: No data reportedPatient perception of improvement: No data reportedAdverse effects: 21/29 [72%] people using topical benzoyl peroxide and 17/30 [57%] people using placebo had redness and peeling (significance not reported)

Ref, reference