Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Lactoperoxidase is an enzyme naturally present in milk and various bodily secretions, and is known for its antimicrobial properties. The primary justification for its use in acne management is scientific, although the evidence supporting its effectiveness is limited and mostly preliminary. Lactoperoxidase works by catalyzing the oxidation of thiocyanate ions in the presence of hydrogen peroxide, resulting in the formation of hypothiocyanite, a compound with notable antimicrobial activity against various bacteria, including some strains involved in acne pathogenesis such as Cutibacterium acnes (formerly Propionibacterium acnes).

Several in vitro studies and a few small clinical trials have suggested that topical formulations containing lactoperoxidase (often as part of the "lactoperoxidase system" with other enzymes like glucose oxidase and lactoferrin) can reduce bacterial counts and may have a mild-to-moderate effect on reducing acne lesions. However, the clinical evidence is not robust: studies are generally small, sometimes industry-sponsored, and results have been mixed regarding the degree of improvement in acne severity compared to established treatments. There is no strong evidence to suggest lactoperoxidase is superior or equivalent to standard acne therapies such as benzoyl peroxide or retinoids.

In summary, while there is a plausible scientific basis and some preliminary evidence supporting lactoperoxidase's use in acne, the overall quality and quantity of evidence is limited. Therefore, it is best considered a supplementary or adjunctive therapy rather than a primary treatment.

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