There are probably thousands of bathroom cabinets across the country that contain half-used tubes of benzoyl peroxide acne products. All too often they are discarded because they can cause irritation to the skin, ‘burning’ off the top layer of skin and making it flake and peel. When you are trying to make your skin better, the last thing you want is for it to become more inflamed! But dermatologists and doctors agree that benzoyl peroxide may be one of the most valuable ingredients nad possibly the best acne treatment around. It is useful at lowering the levels of bacteria on the skin and in the pores, and may therefore help to reduce comedones. If you start off using a low strength of benzoyl peroxide (2.5%), your skin is less likely to react angrily. By building up from once a day to twice a day, your skin will gradually become used to it. If you seem to be getting on well after two months, you can step up to the 5% strength. There is a new formulation (Brevoxyl) that some doctors recommend, which has a good record of causing less irritation: it comes in a 4% strength, which seems very effective and can avoid the need to start with a weak preparation and increase the strength.

As the name suggests (think artificial blonde!), benzoyl peroxide contains bleach. This works by releasing oxygen into the ducts and this kills the bacteria that are one of the causes of acne. The bacteria live in the pores because they don’t like or need oxygen to live, so benzoyl peroxide is a very efficient killer and bacteria cannot become resistant to it. But the bleach will work on other things - clothes, towels and pillow cases - so you need to use old ones that won’t matter if they get spoiled.

Azelaic acid

This preparation comes in cream form and acts in a similar way to benzoyl peroxide. It seems to be less irritant. At present it is available only on prescription from your doctor, but, as the trend is to allow more and more simple treatments to be available over the counter, it may soon be possible to buy it direct from a pharmacist/chemist shop.

Azelaic acid has a potential second use in that it can help to reduce the dark pigmentation that sometimes appears on the skin after the acne has cleared up.

Nicotinamide

This is derived from B vitamins and helps to fight bacteria while ‘calming’ the skin. It is available on special order from your pharmacist or on prescription from your doctor.