benzoyl peroxide + chlorhexidine

Benzoyl peroxide + chlorhexidine is a combination of two antiseptic agents used primarily for skin preparation before surgical procedures, particularly in sebaceous areas. Benzoyl peroxide creates reactive oxygen species that physically associate with bacterial components, exerting a bactericidal effect primarily on gram-positive bacteria such as Staphylococcus, Streptococcus, and Cutibacterium acnes (formerly Propionibacterium acnes). It has a high resistance threshold, making it valuable for preventing or decreasing antibiotic resistance. Chlorhexidine is a rapid-onset, long-lasting, broad-spectrum biocide that disrupts bacterial cell membranes at high concentrations and suppresses cellular respiration at low concentrations. The combination has been studied for its efficacy in reducing bacterial load on the skin, particularly targeting C. acnes in sebaceous areas like the glabella, back, nasal creases, and shoulder. However, studies have shown mixed results regarding the superiority of this combination over chlorhexidine alone for preventing post-operative infections.