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Acne Treatment Helps Some, Not All


is advertised to teenagers and adults as a nonprescription, three-step

treatment for healing acne and preventing future outbreaks. It's touted by its

marketer and distributor, Guthy-Renker Corp., as the No. 1 acne treatment

system in the country, a claim that vice president Karen Barner said is based

on comparing the company's sales figures to ones published by the industry. The

product was created by two doctors, California dermatologists Kathy Fields and

Katie Rodan, each of whom has a private practice and a university affiliation.

The main Proactiv product line, a kit containing a cleanser, toner and

repairing lotion, is marketed on TV infomercials and in magazines. It is

available via the Web or by phone, at a cost of $39.95. You are automatically

enrolled to get a new shipment every 60 days, or you can buy products in the

line individually at a higher price. The active ingredient in both the cleanser

and lotion is 2.5 percent benzoyl peroxide.

WHAT'S KNOWN: There's little surprise in the key ingredient. "Benzoyl

peroxide is benzoyl peroxide," an agent that kills acne-causing bacteria in the

sebaceous glands, said Dr. Diane Madfes, a Manhattan dermatologist and

clinical instructor at Mount Sinai Hospital. Benzoyl peroxide has been around

for years as an acne medication, and studies of its effectiveness date back a

decade or two. Available in prescription and nonprescription forms, its

concentrations typically range from 2 percent to 10 percent. Its biggest plus:

Bacteria have not developed resistance to it. Its biggest problem: It can

irritate your skin.

THE BOTTOM LINE: What really counts is the vehicle that benzoyl peroxide

sits in, said Madfes. In the case of Proactiv, that is dimethicone, a silicone.

Dr. Michelle T. Pelle, a dermatologist and researcher at the University of

Pennsylvania, gave dimethicone high marks for making products easy to spread

and for allowing medications to enter the skin slowly, minimizing irritation.

Another agent, glycolic acid, used in Proactiv's toner, peels the skin and

helps unclog pores. But in a complicated disorder like acne, a

one-size-fits-all system can fall short for some sufferers. Although its Web

site says Proactiv is "the answer to acne," in reality, it's for people with

"mild to moderate acne," said Fields. The rule of thumb for Proactiv: If you

haven't improved within two months, Fields said, go see a dermatologist. Rodan

said 80 percent of the people they studied showed results in four to six weeks,

but their studies are not available to the public. The formula has not changed

since its launch in 1995, and the doctors say they monitor its effectiveness

through "thousands" of letters, phone calls and e-mails from a "loyal


OTHER APPROACHES: Over-the-counter products by Proctor & Gamble, Johnson &

Johnson and SmithKline Beecham have active ingredients including benzoyl

peroxide, salicylic acid or sulfur in a base geared to be nonirritating. Newer

combination prescription drugs are increasingly popular. A recent study of 492

people with moderate to moderately severe acne at the University of

Pennsylvania showed that a combination topical gel of 5 percent benzoyl

peroxide with 1 percent clindomycin, an antibiotic, had better efficacy than

benzoyl peroxide alone or combined with erythromycin, and a similar

tolerability. With so many options, it can be tough to choose a course to take,

especially as people often start with self-diagnosis before seeing a

dermatologist. For example, Pelle said some people think they have acne when

they have rosacea, an acne-like skin condition that could be made worse by

using glycolic or salicylic acid. For many people, the path to controlling acne

is littered with products that didn't work for them. Proactiv has a solution

for that, too. You can get a full refund if you're not satisfied after 60 days.

But don't throw away the bottles in frustration - you have to return them,

whether full or empty, to get your money back.

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