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Herbert P. Goodheart, MD 1971 (Hahnemann Medical College). Acne For Dummies (2006). p. 234.

Benzoyl peroxide is the most commonly used over-the-counter acne medication, and is also the most effective medication for treating PFB. It comes in varying strengths ranging from 2.5 to 10 percent. There’s no proof that anything higher than 2.5 percent works any better than the higher concentration, and the lower concentrations are cheaper and may be less irritating to your skin. Clear By Design, Clearasil, Fostex, Neutrogena, and Noxzema are just a few of the benzoyl peroxide brand names available.

The statement beneath from this abstract feels paradoxical.

The 2.5% benzoyl peroxide formulation was more effective than its vehicle and equivalent to the 5% and 10% concentrations in reducing the number of inflammatory lesions (papules and pustules).

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    It's actually not unusual for the most effective dose of a drug to be a lower one.
    – Carey Gregory
    Aug 5, 2018 at 15:13

1 Answer 1

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You are reading the outcome incorrectly, the 5% and 10% formulations are not less effective, they are equally effective.

The specific text is

The 2.5% benzoyl peroxide formulation was more effective than its vehicle and equivalent to the 5% and 10% concentrations

I don't know how you read that as the higher concentrations are less effective.

The 2.5% formulation was more effective that its vehicle, meaning the solution it was added to.

The correct reading is that whatever mechanism benzoyl peroxide works by is essentially saturated at 2.5%, and a higher concentration is simply wasted.

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  • Welcome to MedicalSciences.SE. Can you please provide a little more detail on how the outcome of the paper by O H Mills Jr et al. (abstract linked in the question) was misread? I believe I have read it in the same way as the OP, that 2.5% was more effective than its vehicle and equivalent to the 5% and 10% concentrations. Not just it's vehicle as that would be a given being as it is not the active ingredient. Oct 27, 2021 at 5:43
  • The specific text is: The 2.5% benzoyl peroxide formulation was more effective than its vehicle and equivalent to the 5% and 10% concentrations I don't know how you read that as the higher concentrations are less effective.
    – Turksarama
    Oct 27, 2021 at 6:01
  • I now see what you and O H Mills Jr et al. are saying @Turksarama and therefore adjusted my downvote to an upvote. My apologies 😊 Oct 27, 2021 at 6:14
  • Rereading the linked page, earlier in the abstract, it does say "A 2.5% formulation of benzoyl peroxide was compared with its vehicle, and with a 5% and a 10% proprietary benzoyl peroxide gel preparation" That makes the quoted text in the question more clear Oct 27, 2021 at 6:16

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