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For further information, see The Ultraviolet Garden.

For further reference, see:

• Rosacea Sunscreens;
• Types of Daylight;
• Invisible Dayight Exposure Produces Dry Skin in Rosacea;
• Sunscreen Use Protects Rosacea Patient Autonomy;
• Flawed Sunscreen Use and Lost "Anti-Aging Effects";
• Paraben Preservatives and Sun Damage;
• General Recommendations for Sun Protection in Rosacea Patients.

Video supplied by Melbourne Dermatology used with permission.

A range of studies published in respectable journals over the years (for example the Cutis study) have suggested or recommended the use of benzoyl peroxide in the treatment of rosacea.

Benzoyl peroxide works by releasing inflammatory free radical oxygen molecules deep within the skin.

The mechanism destroys propionibacterium, the bacteria which in large part causes juvenile acne, and which cannot live in the presence of oxygen.

The free radical oxygen molecules released by benzoyl peroxide are among the most damaging of all the reactive oxygen species and are implicated in premature skin aging (see Oxidative Stress and Free Radical Damage, Melbourne Dermatology) .

Benzoyl peroxide is popular because it is rapidly and permanently effective against juvenile acne bacteria.

This should have nothing to do with rosacea, which although it may appear like acne, lacks actual pathological acne bacteria.

Rosacea is not relieved, otherwise treated or prevented by removing acne-causing bacteria from the skin.

Moreover, benzoyl peroxide is a considerable skin irritant unsuitable for use by those with anything more than moderate skin sensitivity, irrespective of skin condition.

Benzoyl peroxide can cause severe flushing, redness and dryness in almost all individuals.

These symptoms are also those which rosacea patients are supposed to avoid because their occurrence encourages disease progression.

More About Benzoyl Peroxide

The active constituent of benzoyl peroxide is peroxide, just as you would find in bleach, which is why the ingredient has a tendency to redden brown hair and take colour from fabrics.

The benzoyl component is required to force the peroxide to penetrate the skin.

Other forms of peroxide are used in teeth whitening products and hair colourants and include hydrogen peroxide, carbamide peroxide and calcium peroxide.

Benzoyl Peroxide Treatment Conclusions

Benzoyl peroxide is a pro-inflammatory skin irritant.

Improvements in rosacea following its use are short-lived and likely due to skin exfoliation which may be achieved by more beneficial and sustainable means. Rosacea Micro-Exfoliating Cream and RosaTox Soothing Mask Powder provide some skin-calming alternatives.

The ongoing investigation and use of benzoyl peroxide in the treatment of rosacea is significantly deleterious to patients and likely reflects embarrassingly inadequate or dated training on the behalf of dermatologists and other physicians whom fail to distinguish between "acne" and "rosacea."

The disease moniker "acne rosacea" probably assists the perpetuation of such poor rosacea treatments for its suggestion that acne bacteria are involved.

To avoid permanent worsening of your rosacea, do not use benzoyl peroxide.

If you have juvenile or otherwise conventional inflammatory acne, it is worth considering that benzoyl peroxide, while effective, is not your best or only option unless the cost of treatment is your overarching concern, and that its use may age your skin prematurely.

Recovering from Benzoyl Peroxide Treatment1>

As with all inappropriate skin care, burning, stinging and itching can persist even after poor use has come to an end.

More often than not, simply stopping the use of benzoyl peroxide is inadequate for recovery within a reasonable period of time.

Additionally, leaving the skin fragile and poorly defended is likely to encourage skin reactivity such that ordinarily beneficial skincare will also fail.

The first stage of recovery is to strengthen your skin's natural barrier (refer: Healthy Skin Barrier, Melbourne Dermatology).

• Avoid soaps, foaming cleansers (refer Sodium Laureth Sulphate, Melbourne Dermatology) and herbal and aromatherapeutic cleansing milks (refer Skin Care Failure: Organic/Natural, Melbourne Dermatology), irrespective of any marketing claims made regarding their suitability for sensitive skin. We recommend Rosacea De-Sensitizing Cleansing Emulsion as an optimal cleansing solution containing gentle but potent anti-inflammatories and highly effective non-comedogenic moisturizers that protect your skin and it's precious moisture during cleansing.
  
  
• Supplement your skin's moisture content with light, non-comedogenic skin hydrators which don't lose their effectiveness within a few hours of use. Use Rosacea Hydrating De-Sensitizing Mist immediately after cleansing to remove impurities in tap water from skin and avoid moisture loss before applying your moisturizer. Rosacea Hydrating Serum is a peerless moisturizer and may be applied alone, underneath or mixed with any Rosacea Moisturizer.
  
  
• Moisturize and protect with rosacea-specific products which repair and protect the skin's barrier using high concentrations of only the best and lightest moisturizers. Any of the rosacea moisturizers achieve this aim, however if skin is extremely damaged or you need the most rapid improvement attainable, a one or two week course of Rosacea Intensive 1-Week Recovery Complex is optimal.
  
  
• Avoid the sun as much as you can, but when exposed (even if only briefly) use a suitable rosacea sunscreen, preferably one containing soothing zinc oxide rather chemical blocks, such as Hypoallergenic Daily Wear Sunscreen SPF 20.

Lastly and critically, be patient and reasonable.

Avoid changing your skin care during the recovery period — it's been through enough and will thank you if you avoid subjecting it to new treatment challenges every few days.

Slow and steady wins the race to recovery from benzoyl peroxide treatment.

Examples of Skin Care Products containing Benzoyl Peroxide

Examples of benzoyl peroxide products include Proactiv, Obagi Clenziderm, Pan Oxyl, PCA Skin BPO 5% Cleanser, Dermalogica Special Clearing Booster, B. Kamins Medicated Acne Gel, some Clearasil products and Loroxide Acne Lotion.

Products vary in their concentration of benzoyl peroxide, efficacy, individual suitability and tendency to cause irritation.

A parallel group of patients was treated with a matching placebo (acetone gel vehicle). At the end of the first four weeks of treatment the dropout rate due to lack of improvement was 23 and 63 percent for benzoyl peroxide acetone gel and placebo, respectively.

Benzoyl peroxide acetone gel was superior to placebo with respect to improvement in the overall severity of the lesions when judged by photographs, and by reduction of erythema, papules, and pustules.

Results after treatment with benzoyl peroxide acetone gel were better during weeks five to eight than during weeks one to four for all lesions except telangiectasia.

Benzoyl peroxide acetone gel was superior to placebo when the overall responses were compared. In addition, the benzoyl peroxide acetone gel-treated group, but not the placebo-treated group, showed a significantly better response during weeks five to eight compared to weeks one to four.