Microencapsulated Benzoyl Peroxide Rapidly, Significant Improves Rosacea

Hilary Baldwin, MD

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Topical microencapsulated benzoyl peroxide 5% was associated with reduced inflammatory lesions in patients with rosacea over 40 weeks, according to findings from a pair of phase 3 analysis.

In pooled data presented at the Maui Derm 2023 NP + PA Summer Conference in Colorado Springs this week, a team of US investigators reported that a microencapsulated cream form of the popular rosacea treatment provided both rapid onset and sustained benefit in the treatment of rosacea.

Led by Hilary Baldwin, MD, of the Acne Treatment and Research Center in New York, investigators sought to assess the encapsulated form of benzoyl peroxide, a formulation designed to “extend drug delivery time and potently reduce the potential for irritation”—a potential improvement to a therapy that has generally not been considered a first-line therapy for rosacea.

“Benzoyl peroxide has a marked ability to clear rosacea lesions; however, use of traditional benzoyl peroxide formulations is limited by cutaneous irritation,” Balwdin and colleagues wrote. “In addition, benzoyl peroxide may cause irritant contact dermatitis, and, rarely, allergic contact dermatitis.”

In an interview with HCPLive during Maui Derm 2023, Baldwin noted that benzoyl peroxide is among a litany of relatively new topical options that have come to revolutionize rosacea care in the last decade; with the surge of such therapies, dermatologists have set higher standards for rosacea resolution.

“We have ample evidence now that if you go all the way to clear (skin), your chances of staying clear and being able to go on a drug holiday are much improved,” Baldwin said. “In fact, with our newer topical medications, we have some evidence that the recurrence rate across the board is less. There are patients who never seem to have rosacea again, and we just never saw that before.”

The novel formulation of benzoyl peroxide consisted of amorphous silica forms interconnected among colloidal particles until a rigid network of gel is formed with submicron-dimensioned pores. “Silica shells control the release rate of benzoyl peroxide onto the skin, allowing a therapeutic effect while minimizing side effects and optimizing tolerability,” investigators wrote.

In 2 separate phase 3 studies assessing the once-daily agent with 733 patients diagnosed with papulopustular rosacea, investigators observed an onset of clinical action among treated patients by week 2, and significantly superior efficacy compared to vehicle. Mean tolerability was consistent among patients treated with benzoyl peroxide compared to vehicle, and remained low in severity throughout the treatment period.

A separate 40-week extension trial showed more than 95% of patients receiving the benzoyl peroxide formulation reported mild to no adverse events. Another two-thirds (67.2%) of patients achieved an Investigators Global Assessment (IGA) score of 0 or 1, indicating clear or almost clear skin.

“(Micrencapsulated benzoyl peroxide) effectively reduced inflammatory rosacea lesions with good tolerability and safety,” investigators concluded. “(It) has been formulated as a topical monotherapy for rosacea and in combination with tretinoin for acne vulgaris.”

References

1. ^{Baldwin H, Elewski B, Levy-Hacham O, Hougier F. Evolution of Benzoyl Peroxide: Microencapsulated 5% Cream to Improve Tolerability in Papulopustular Rosacea. Abstract presented at: Maui Derm 2023 NP + PA Summer Conference, Colorado Springs, CO, June 22 – 25, 2023.}
2. ^{Kunzmann K. Hilary Baldwin, MD: The Surge of Rosacea Treatment Options. HCPLive. Published June 23, 2023. https://www.hcplive.com/view/hilary-baldwin-md-surge-rosacea-treatment-options}