Benzoyl Peroxide's Sensitisation Potential and Potency in Experimental Methods and Review of Contact Allergy and Allergic Contact Dermatitis

Positive patch test responses to benzoyl peroxide (BPO) have been reported from patients without and with known exposure. Up to 6.5% were found in the United States and 7.8% in a study including patients from Germany, Austria and Switzerland. We provide an overview of the skin sensitisation potential and potency of BPO based on animal experiments and non-animal methods. BPO tested positive in Guinea Pig Tests and the Local Lymph Node Assay. Application of the current OECD guideline to identify a skin sensitizer by combining non-animal method results gave differing outcomes. Moreover, patch test responses of patients to BPO were considered to determine the importance of BPO as a relevant occupational contact allergen. Another well-known BPO exposure is the topical application to treat acne. Despite widespread use, extensive and long-term skin exposure, we found for this group only studies reporting few positive patch test reactions. Further, occupational handling of BPO and contact allergy is reported by dental technicians. In-depth evaluation of the prevalence of contact allergy in different professions with suspected BPO exposure did not reveal an association with occupational handling of BPO. Consequently, a generally increased risk for those professions is not supported.