How does benzoyl peroxide work against acne. What are the off-label uses of benzoyl peroxide. How should benzoyl peroxide be applied for maximum effectiveness. What are the potential side effects of benzoyl peroxide. Who should avoid using benzoyl peroxide.

Understanding Benzoyl Peroxide: A Powerful Acne-Fighting Agent

Benzoyl peroxide is a widely used topical medication for treating acne vulgaris. Available both over-the-counter and by prescription, this versatile compound has earned its place as a staple in acne treatment regimens. Its effectiveness stems from its ability to combat multiple factors contributing to acne formation.

The Science Behind Benzoyl Peroxide’s Acne-Fighting Power

Benzoyl peroxide’s primary mechanism of action involves its bactericidal effects against Cutibacterium acnes (C. acnes), a bacterium closely associated with acne development. Upon application to the skin, benzoyl peroxide undergoes a transformation into benzoic acid. This process triggers the release of active free-radical oxygen species, which effectively oxidize bacterial proteins, thereby neutralizing C. acnes.

The impact of benzoyl peroxide on acne-causing bacteria is remarkably swift and potent. Studies have shown that applying a 10% benzoyl peroxide solution daily for just two weeks can reduce C. acnes populations in hair follicles by an astounding 98%. This rapid action outpaces even some antibiotic treatments, which may require up to four weeks to achieve similar results.

Beyond Bacteria: Benzoyl Peroxide’s Multifaceted Approach

While its antibacterial properties are impressive, benzoyl peroxide’s acne-fighting capabilities extend beyond simply killing bacteria. This compound also exhibits mild sebostatic effects, helping to regulate sebum production – a key factor in acne development. Additionally, benzoyl peroxide possesses keratolytic properties, which aid in the removal of dead skin cells that can clog pores and contribute to comedone formation.

Furthermore, benzoyl peroxide has been shown to reduce the levels of free fatty acids on the skin surface by approximately 50% after two weeks of daily use. This reduction in lipids plays a crucial role in minimizing the skin’s inflammatory response, which is often a significant component of acne lesions.

Exploring the Versatility of Benzoyl Peroxide: Off-Label Uses

While primarily known for its acne-fighting prowess, benzoyl peroxide has demonstrated efficacy in treating a variety of other skin conditions. These off-label uses showcase the compound’s versatility and potential broader applications in dermatology.

• Inflammatory forms of rosacea
• Folliculitis (including gram-negative, non-infectious, and drug-induced variants)
• Pseudo-folliculitis barbae
• Progressive macular hypomelanosis
• Pressure ulcers
• Perforating diseases
• Pitted keratolysis

In the case of cutaneous ulcers, benzoyl peroxide has shown promise in stimulating the production of healthy granulation tissue and promoting rapid epithelial ingrowth. This property makes it a potentially valuable tool in wound healing and management.

Optimal Application: Maximizing Benzoyl Peroxide’s Effectiveness

To harness the full potential of benzoyl peroxide, proper application is crucial. The compound is available in various concentrations and formulations, each designed for specific uses and skin types.

Concentration Options

Benzoyl peroxide products typically come in concentrations of 2.5%, 5%, and 10%. Higher concentrations may provide more potent effects but also carry an increased risk of skin irritation. For many individuals, starting with a lower concentration and gradually increasing as tolerated can help minimize side effects while still achieving desired results.

Formulation Varieties

The versatility of benzoyl peroxide is evident in its wide range of available formulations, including:

• Lotions
• Creams
• Gels
• Foams
• Solutions
• Cleansing bars
• Cleansing lotions
• Cloths
• Pads
• Masks
• Shaving creams

Each formulation has specific instructions for use. For instance, cleansing bars and washes are typically used one to three times daily, while masks are designed for weekly application, left on for 15 to 25 minutes before rinsing.

Combination Therapies: Enhancing Efficacy

Research has consistently shown that combination products containing benzoyl peroxide alongside other active ingredients often yield superior results compared to monotherapy. Two notable combinations include:

1. Benzoyl peroxide with topical antibiotics (e.g., erythromycin or clindamycin): These combinations are typically applied twice daily and have shown enhanced efficacy in treating acne vulgaris.
2. Benzoyl peroxide with adapalene: This once-daily combination has demonstrated improved results over either medication used alone.

These combination therapies leverage the complementary mechanisms of action of different active ingredients to provide more comprehensive acne treatment.

Navigating Potential Side Effects: What to Watch For

While benzoyl peroxide is generally well-tolerated, users should be aware of potential side effects to ensure safe and effective use.

Common Side Effects

The most frequently reported side effect of benzoyl peroxide is its bleaching property. Users should exercise caution to avoid contact with colored fabrics or hair, as discoloration may occur. At higher concentrations, benzoyl peroxide can cause mild skin dryness, erythema, and scaling. These effects are typically manageable and often subside as the skin adjusts to treatment.

Contact Dermatitis: A Rare but Important Consideration

In a small percentage of users, benzoyl peroxide may cause contact dermatitis. Individuals who develop marked erythema and irritation at the treatment site should discontinue use and consult a healthcare provider. This reaction, while uncommon, underscores the importance of monitoring one’s skin response to the treatment.

Who Should Exercise Caution with Benzoyl Peroxide?

While benzoyl peroxide is safe for most individuals, certain groups should approach its use with caution or avoid it altogether.

Hypersensitivity Concerns

Individuals with a known history of hypersensitivity to benzoyl peroxide should not use products containing this compound. Additionally, those with sensitivities to cinnamon or other benzoic acid derivatives should be cautious, as cross-reactivity may occur.

Application Site Considerations

Benzoyl peroxide is not recommended for use around sensitive areas such as the eyes, nose, mouth, or mucous membranes. These regions are more susceptible to irritation and adverse reactions.

Benzoyl Peroxide and Antibiotic Resistance: A Unique Advantage

One of the most notable benefits of benzoyl peroxide in acne treatment is its apparent resistance to bacterial adaptation. Unlike many topical antibiotics, which can lead to the development of resistant bacterial strains over time, benzoyl peroxide has not been associated with such resistance.

The Mechanism Behind Resistance Prevention

The reason for benzoyl peroxide’s resistance-proof nature lies in its mode of action. Unlike antibiotics that target specific bacterial processes, benzoyl peroxide’s oxidative effects are broad and non-specific. This makes it extremely difficult for bacteria to develop adaptive mechanisms that could render the treatment ineffective.

Implications for Long-Term Acne Management

The lack of resistance development with benzoyl peroxide use has significant implications for long-term acne management strategies. It allows for sustained effectiveness over extended periods, making it an excellent choice for maintenance therapy or as part of a combination regimen to help prevent the emergence of antibiotic-resistant strains.

Benzoyl Peroxide in Clinical Practice: Improving Patient Outcomes

The effective use of benzoyl peroxide in clinical settings requires a coordinated approach among healthcare providers. Dermatologists, primary care physicians, pharmacists, and nurses all play crucial roles in optimizing patient outcomes.

The Role of the Interprofessional Team

A well-coordinated interprofessional team can significantly enhance the effectiveness of benzoyl peroxide treatment:

• Dermatologists and primary care physicians can assess the severity of acne, recommend appropriate concentrations and formulations, and monitor treatment progress.
• Pharmacists can provide valuable information on proper application techniques, potential drug interactions, and strategies to minimize side effects.
• Nurses can offer patient education on skincare routines, help manage expectations, and provide support for adherence to treatment regimens.

Patient Education: Key to Success

Educating patients about the proper use of benzoyl peroxide is crucial for achieving optimal results. This includes guidance on:

1. Correct application techniques and frequency
2. The importance of sun protection during treatment
3. Managing potential side effects like dryness and irritation
4. The need for patience, as visible improvements may take several weeks
5. The importance of consistent use for maintaining results

By providing comprehensive education and support, healthcare providers can help patients maximize the benefits of benzoyl peroxide while minimizing potential drawbacks.

Future Directions: Expanding the Potential of Benzoyl Peroxide

As research in dermatology continues to advance, new applications and formulations of benzoyl peroxide may emerge. Current areas of investigation include:

Novel Delivery Systems

Researchers are exploring innovative delivery systems to enhance the penetration and efficacy of benzoyl peroxide while minimizing irritation. These may include nanoparticle formulations or time-release technologies that could provide more consistent drug delivery over extended periods.

Combination Therapies

While benzoyl peroxide is already used effectively in combination with antibiotics and retinoids, ongoing studies are investigating its potential synergies with other active ingredients. This could lead to more targeted and effective treatment options for various skin conditions.

Expanded Applications

Given its versatility, benzoyl peroxide may find new applications beyond its current uses. Researchers are exploring its potential in treating other dermatological conditions or as an adjunct therapy in wound healing and skin rejuvenation.

As our understanding of skin biology and the mechanisms of various dermatological conditions deepens, the role of benzoyl peroxide in clinical practice may continue to evolve and expand. Its proven efficacy, safety profile, and resistance to bacterial adaptation make it a valuable tool in the dermatologist’s arsenal, with potential for even greater impact in the future.

Benzoyl Peroxide – StatPearls – NCBI Bookshelf

Taraneh Matin; Marcus B. Goodman.

Author Information and Affiliations

Last Update: October 10, 2022.

Continuing Education Activity

Benzoyl peroxide is an over-the-counter topical medication and is also an FDA-approved prescription medication for the treatment of acne vulgaris. It is bactericidal with activity against Cutibacterium acnes on the skin and within the hair follicles. This activity outlines the indications, mechanism of action, safe administration, adverse effects, contraindications, toxicology, and monitoring of the broad array of physiological possibilities when using benzoyl peroxide in the clinical setting.

Objectives:

• Identify the indications for benzoyl peroxide use.

• Summarize the mechanism of action of benzoyl peroxide.

• Describe the most common adverse effects associated with benzoyl peroxide use.

• Outline the importance of improving care coordination among the interprofessional team to improve outcomes for patients using benzoyl peroxide.

Access free multiple choice questions on this topic.

Indications

Benzoyl peroxide is an over-the-counter topical medication and is also an FDA-approved prescription medication for the treatment of acne vulgaris. It is bactericidal with activity against Cutibacterium acnes (C. acnes) on the skin and within the hair follicles. Benzoyl peroxide has mild sebostatic and keratolytic effects and is most effective when used combined with other acne vulgaris therapies.[1][2] In contrast to other topical antibiotics, drug resistance has not appeared to develop with benzoyl peroxide use.[1]

Off-label indications for benzoyl peroxide include[3][4][5][6][7]:

• Inflammatory forms of rosacea 

• Folliculitis including gram-negative folliculitis, non-infectious folliculitis, and drug-induced folliculitis (acneiform eruptions)

• Pseudo-folliculitis barbae

• Progressive macular hypomelanosis 

• Pressure ulcers

• Perforating diseases

• Pitted keratolysis

Mechanism of Action

Topical benzoyl peroxide exhibits bactericidal effects against Cutibacterium acnes, a key component of acne vulgaris. [1][2] Benzoyl peroxide, once absorbed by the skin, is converted to benzoic acid. Approximately 5% of the benzoic acid is systemically absorbed and excreted by the renal system. The remaining benzoic acid is metabolized by cysteine in the skin, releasing active free-radical oxygen species resulting in the oxidization of bacterial proteins.[8] Improvement of acne vulgaris occurs by reducing lipids, free fatty acids, and P. acnes.

After applying 10% benzoyl peroxide daily for two weeks, the amount of P. acnes in hair follicles decreased by 98%, and the amount of free fatty acids decreased by 50%, which is comparable to results obtained after four weeks of antibiotic therapy.[9] Topical benzoyl peroxide also has mild sebostatic effects contributing to its keratolytic activity and efficacy in treating comedonal acne.[1] Benzoyl peroxide effectively treats cutaneous ulcers through stimulation of healthy production of granulation tissue and rapid ingrowth of epithelium.[10] 

Administration

Benzoyl peroxide is available as both over-the-counter and prescription formulations in concentrations of 2. 5%, 5%, and 10%. Available preparations include lotions, creams, gels, foams, solutions, cleansing bars, cleansing lotions, cloths, pads, masks, and shaving creams.  Each application vehicle has specific instructions for the frequency of use. Cleansing bars and washes are used one to three times a day, whereas mask application is a thin layer that is left on for 15 to 25 minutes once a week.[11] Studies have shown that to treat acne vulgaris, the combination products containing benzoyl peroxide and topical antibiotics or adapalene are more effective than either medication used alone.[12][13] Combination preparations with erythromycin or clindamycin are applied twice daily, whereas combination preparations with adapalene are applied once daily.[11]

Adverse Effects

The most common adverse effect from benzoyl peroxide is its bleaching quality, potentially causing the discoloration of colored fabrics and bleaching of hair.  At higher concentrations, topical benzoyl peroxide causes mild dryness, erythema, and scaling. [14] There are also case reports of contact dermatitis in a small percentage of patients, which should arouse suspicion in patients who develop marked erythema and irritation at the treatment site. In such instances, the prudent course of action is to discontinue the use of benzoyl peroxide.

Contraindications

Patients who present with a known history of hypersensitivity to benzoyl peroxide should not use benzoyl peroxide products. Patients with hypersensitivity to cinnamon and other benzoic acid derivatives should be cautious in using benzoyl peroxide as cross-reactivity may occur.[15]

Benzoyl peroxide is not indicated for use around the eyes, nose, mouth, mucous membranes, and open skin as it may cause severe irritation. In instances of mucous membrane or ocular contact, thoroughly rinse affected areas with water for a minimum of 15 minutes.

Patients should limit their UV exposure and apply sunscreen to decrease the risk of developing phototoxicity and skin irritation. [14] 

Children

There is little data available supporting the clinical safety and efficacy of benzoyl peroxide when used in children. Because of its minimal systemic absorption, topical benzoyl peroxide is generally regarded as being safe in the pediatric population.[16] 

Pregnancy

The FDA classifies benzoyl peroxide as pregnancy risk category C. The effects of benzoyl peroxide on reproductive health and fetal health are unknown. However, because of its minimal systemic absorption, topical application of benzoyl peroxide is generally considered safe during pregnancy.[17] 

Breast-feeding

There is not much data available on the use of benzoyl peroxide while breastfeeding. Because of its low rate of systemic absorption, minimal risk to the infant is likely, and the topical use of benzoyl peroxide is generally regarded as safe while breastfeeding, as long as its application is not where the infant would have direct contact during breastfeeding or close skin-on-skin contact. [17]

Drug Interactions

• Patients should avoid concomitant use of topical sulfone products (e.g., dapsone) with topical benzoyl peroxide as it reportedly causes yellowing of the skin and facial hair.[18] 

• Patients should avoid concomitant use of topical hydroquinone with topical benzoyl peroxide as it may result in increased skin irritation and transient staining of the epidermis.[19]

• Concomitant use of oral isotretinoin with topical benzoyl peroxide has been reported to result in increased skin irritation and dryness.[20] 

• Patients should avoid concurrent application of topical benzoyl peroxide with topical tretinoin as it results in decreased efficacy of tretinoin. Unlike tretinoin, adapalene is resistant to oxidation by benzoyl peroxide and is an acceptable combination product.[2]

• Concomitant use of topical anesthetics with topical benzoyl peroxide reportedly decreases the efficacy of anesthetics. For optimal results, the recommendation is to thoroughly wash the treatment area before applying topical anesthetics.[21]

Monitoring

There are no monitoring parameters identified for benzoyl peroxide, and no routine tests are recommended. Development of contact dermatitis to benzoyl peroxide should be monitored, with discontinuation of the medication in patients that develop marked erythema and irritation with its use. Before using benzoyl peroxide, a test area should have a test treatment to monitor for tolerability and sensitivity.[14][15]

Toxicity

Topical benzoyl peroxide is not to be taken by mouth; indications are strictly limited to topical use. In case of ingestion, patients should call 911, contact the poison control center (1-800-222-1222), or report to the nearest emergency department. There are no known antidotes for this medication.

Enhancing Healthcare Team Outcomes

The most common medications prescribed for acne vulgaris include benzoyl peroxide, retinoids, and topical/oral antibiotics. Despite their individual efficacy in treating mild-to-moderate acne vulgaris, studies have shown that the combined use of antibiotics or retinoids with benzoyl peroxide is more efficacious than either medication used alone. The combination is believed to be synergistic and has also been shown to prevent the development of antibiotic resistance.[2][12] However, in a survey of patients with an indication for benzoyl peroxide as an additional acne treatment, only 30% of the patients obtained the benzoyl peroxide product.[22] Therefore, to improve patient compliance and treatment efficacy, healthcare providers should seek to prescribe combination products that would result in simpler skincare regimens and greater patient adherence. The initial disadvantage of combination products is their increased cost and need to be refrigerated to prevent degradation.[11] Although refrigeration is encouraged, cost reduction is possible through the utilization of specialty compounding pharmacies.

Review Questions

• Access free multiple choice questions on this topic.

• Comment on this article.

References

1.

Kircik LH. The role of benzoyl peroxide in the new treatment paradigm for acne. J Drugs Dermatol. 2013 Jun 01;12(6):s73-6. [PubMed: 23839205]

2.

Zaenglein AL. Acne Vulgaris. N Engl J Med. 2018 Oct 04;379(14):1343-1352. [PubMed: 30281982]

3.

Leyden JJ. Topical treatment for the inflamed lesion in acne, rosacea, and pseudofolliculitis barbae. Cutis. 2004 Jun;73(6 Suppl):4-5. [PubMed: 15228127]

4.

Wu XG, Xu AE, Luo XY, Song XZ. A case of progressive macular hypomelanosis successfully treated with benzoyl peroxide plus narrow-band UVB. J Dermatolog Treat. 2010 Nov;21(6):367-8. [PubMed: 20524876]

5.

Fernández Vozmediano JM, Alonso Blasi N, Almenara Barrios J, Alonso Trujillo F, Lafuente L. [Benzoyl peroxide in the treatment of decubitus ulcers]. Med Cutan Ibero Lat Am. 1988;16(5):427-9. [PubMed: 3070200]

6.

Lukács J, Schliemann S, Elsner P. Treatment of acquired reactive perforating dermatosis – a systematic review. J Dtsch Dermatol Ges. 2018 Jul;16(7):825-842. [PubMed: 29927512]

7.

Vlahovic TC, Dunn SP, Kemp K. The use of a clindamycin 1%-benzoyl peroxide 5% topical gel in the treatment of pitted keratolysis: a novel therapy. Adv Skin Wound Care. 2009 Dec;22(12):564-6. [PubMed: 19935134]

8.

Nacht S, Yeung D, Beasley JN, Anjo MD, Maibach HI. Benzoyl peroxide: percutaneous penetration and metabolic disposition. J Am Acad Dermatol. 1981 Jan;4(1):31-7. [PubMed: 7204686]

9.

Nacht S, Gans EH, McGinley KJ, Kligman AM. Comparative activity of benzoyl peroxide and hexachlorophene. In vivo studies against propionibacterium acnes in humans. Arch Dermatol. 1983 Jul;119(7):577-9. [PubMed: 6222704]

10.

O’Meara SM, Cullum NA, Majid M, Sheldon TA. Systematic review of antimicrobial agents used for chronic wounds. Br J Surg. 2001 Jan;88(1):4-21. [PubMed: 11136304]

11.

Hoffman LK, Bhatia N, Zeichner J, Kircik LH. Topical Vehicle Formulations in the Treatment of Acne. J Drugs Dermatol. 2018 Jun 01;17(6):s6-s10. [PubMed: 29879262]

12.

Leyden JJ, Wortzman M, Baldwin EK. Antibiotic-resistant Propionibacterium acnes suppressed by a benzoyl peroxide cleanser 6%. Cutis. 2008 Dec;82(6):417-21. [PubMed: 19181031]

13.

Leyden JJ, Thiboutot D, Shalita A. Photographic review of results from a clinical study comparing benzoyl peroxide 5%/clindamycin 1% topical gel with vehicle in the treatment of rosacea. Cutis. 2004 Jun;73(6 Suppl):11-7. [PubMed: 15228129]

14.

Foti C, Romita P, Borghi A, Angelini G, Bonamonte D, Corazza M. Contact dermatitis to topical acne drugs: a review of the literature. Dermatol Ther. 2015 Sep-Oct;28(5):323-9. [PubMed: 26302055]

15.

Shwereb C, Lowenstein EJ. Delayed type hypersensitivity to benzoyl peroxide. J Drugs Dermatol. 2004 Mar-Apr;3(2):197-9. [PubMed: 15098979]

16.

Coughlin CC, Swink SM, Horwinski J, Sfyroera G, Bugayev J, Grice EA, Yan AC. The preadolescent acne microbiome: A prospective, randomized, pilot study investigating characterization and effects of acne therapy. Pediatr Dermatol. 2017 Nov;34(6):661-664. [PubMed: 29024079]

17.

Pugashetti R, Shinkai K. Treatment of acne vulgaris in pregnant patients. Dermatol Ther. 2013 Jul-Aug;26(4):302-11. [PubMed: 23914887]

18.

Dubina MI, Fleischer AB. Interaction of topical sulfacetamide and topical dapsone with benzoyl peroxide. Arch Dermatol. 2009 Sep;145(9):1027-9. [PubMed: 19770443]

19.

Saade DS, Maymone MBC, Secemsky EA, Kennedy KF, Vashi NA. Patterns of Over-the-counter Lightening Agent Use among Patients with Hyperpigmentation Disorders: A United States-based Cohort Study. J Clin Aesthet Dermatol. 2018 Jul;11(7):26-30. [PMC free article: PMC6057735] [PubMed: 30057662]

20.

Chernyshov PV, Tomas-Aragones L, Manolache L, Svensson A, Marron SE, Evers AWM, Bettoli V, Jemec GB, Szepietowski JC. Which acne treatment has the best influence on health-related quality of life? Literature review by the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes. J Eur Acad Dermatol Venereol. 2018 Sep;32(9):1410-1419. [PubMed: 29729107]

21.

Burkhart CG, Burkhart CN. Decreased efficacy of topical anesthetic creams in presence of benzoyl peroxide. Dermatol Surg. 2005 Nov;31(11 Pt 1):1479-80. [PubMed: 16416626]

22.

Huyler AH, Zaenglein AL. Adherence to over-the-counter benzoyl peroxide in patients with acne. J Am Acad Dermatol. 2017 Oct;77(4):763-764. [PubMed: 28917458]

Disclosure: Taraneh Matin declares no relevant financial relationships with ineligible companies.

Disclosure: Marcus Goodman declares no relevant financial relationships with ineligible companies.

What is Benzoic Acid and Can it Help Clear Acne?

Benzoic Acid Forms from the Breakdown of Benzoyl Peroxide on the Skin. Once it Forms, Benzoic Acid Is Hypothesized to Work Similarly to Salicylic Acid to Clear Acne.

The Essential Info

When benzoyl peroxide is applied to the skin, it breaks down into two parts:

1. Hydrogen peroxide: Hydrogen peroxide works by killing acne bacteria (C. acnes).
2. Benzoic acid: It is unclear exactly what role benzoic acid plays in clearing acne. Some believe it might work similarly to salicylic acid, a commonly used over-the-counter acne treatment by:

   – Exfoliating the skin
   – Reducing inflammation
   – Clearing clogged pores
   – Reducing bacteria

The Science

• Benzoic Acid’s Similar Chemical Structure to Salicylic Acid
• It is Unclear How Effective Benzoic Acid is at Clearing Acne
• Side Effects of Benzoic Acid

Benzoyl peroxide is a commonly used topical acne medication. When benzoyl peroxide is applied to the skin it breaks down into two components:

1. Hydrogen peroxide: Hydrogen peroxide works by killing off acne bacteria (C. acnes).
2. Benzoic acid: The exact effects of benzoic acid are still unknown.

Benzoyl peroxide is effective at clearing acne.^1-4 But, researchers do not know whether the ability of benzoyl peroxide to clear acne is due to the bacteria-killing properties of hydrogen peroxide or might also be partly due to the unknown properties of benzoic acid.

Benzoic acid has a similar chemical structure to salicylic acid, another common topical acne medication that is somewhat effective at clearing acne. Therefore, it is hypothesized that benzoic acid may work in a similar way to salicylic acid, by:

• Exfoliating the skin
• Reducing inflammation
• Clearing clogged pores
• Reducing bacteria

To date, there is no direct scientific study that confirms this. Therefore, more research is needed to confirm that benzoic acid does indeed work to clear acne in a similar way to salicylic acid.

Outside of its potential medicinal role, benzoic acid is widely used as a preservative that is added to many foods, beverages, and skincare products.

When it comes to skincare products, the Cosmetic Ingredient Review Expert Panel has concluded that it is safe to include benzoic acid as an ingredient at concentrations up to 5%.^5,6

Benzoic Acid’s Similar Chemical Structure to Salicylic Acid

The structure of benzoic acid is so similar to that of salicylic acid that scientists can use benzoic acid as a foundation for creating salicylic acid in the laboratory. In other words, the structures are so similar that scientists can easily convert one into the other.

Because the chemical structures of benzoic acid, salicylic acid, and lipohydroxy acid are similar, and this leads scientists to predict that benzoic acid may have similar effects to that of salicylic acid and lipohydroxy acid on the skin. ^7-10

Benzoic Acid Might Act Similarly to Salicylic Acid on the Skin

In order to understand what effects benzoic acid might have on the skin, let’s explore the known effects of salicylic acid on the skin.

Salicylic acid–and possibly benzoic acid–works to clear acne by:

• Exfoliating the skin: Skin exfoliation is a process through which a chemical, such as salicylic acid, stimulates the shedding of dead skin cells from the skin. This helps to unclog pores and clear acne. Salicylic acid stimulates skin exfoliation, which can help to unclog pores and clear acne.
• Reducing inflammation: Acne is an inflammatory disease, and inflammation is present and important for all stages of acne lesion development. By reducing inflammation, salicylic acid can help prevent the formation of new acne lesions and help to treat already-formed acne lesions.
• Reducing skin oil (sebum): Skin oil (sebum) is a big part in acne development. When sebum gets trapped in a clogged pore, acne is born. Salicylic acid mixes easily with oils, so it is able to completely dissolve in sebum, which helps unclog pores.
• Reducing bacteria: Salicylic acid has antibacterial properties, meaning that it can kill bacteria. In acne, C. acnes bacteria grows inside acne lesions making them worse by increasing inflammation inside the clogged pore. Reducing the amount of bacteria inside the pore may help to clear acne.^2,3

It is Unclear How Effective Benzoic Acid is at Clearing Acne

There are no studies that directly investigate how well benzoic acid by itself treats acne. This means that no one knows how well benzoic acid works by itself to clear acne.

Since there are no studies investigating the effectiveness of benzoic acid, we have to rely on studies investigating the effectiveness of benzoyl peroxide.

Research has found that benzoyl peroxide, in concentrations of 2.5%-10%, can generally clear 45%-65% of acne lesions, and when used correctly can clear the skin 100%. It is unclear what percentage of this acne clearance is due to hydrogen peroxide and what percentage is due to benzoic acid, but it is quite possible that benzoic acid might be an important part of the effectiveness of benzoyl peroxide.

Side Effects of Benzoic Acid

Both benzoyl peroxide and benzoic acid are safe for human use and cause only mild side effects in most people.

Higher concentrations of benzoyl peroxide, and presumably benzoic acid, can cause more side effects, including mild skin irritation and dryness.^3,4,11,12

References

1. Nacht, S., Yeung, D., Beasley, J.N., Jr., Anjo, M.D. & Maibach, H.I. Benzoyl peroxide: percutaneous penetration and metabolic disposition. J Am Acad Dermatol 4, 31-7 (1981). https://www.ncbi.nlm.nih.gov/pubmed/7204686
2. Dutil, M. Benzoyl peroxide: enhancing antibiotic efficacy in acne management. Skin Therapy Lett 15, 5-7 (2010). https://www.ncbi.nlm.nih. gov/pubmed/21076800
3. Mueller, R.S., Bergvall, K., Bensignor, E. & Bond, R. A review of topical therapy for skin infections with bacteria and yeast. Vet Dermatol 23, 330-41, e62 (2012). https://www.ncbi.nlm.nih.gov/pubmed/22731400
4. Sagransky, M., Yentzer, B.A. & Feldman, S.R. Benzoyl peroxide: a review of its current use in the treatment of acne vulgaris. Expert Opin Pharmacother 10, 2555-62 (2009). https://www.ncbi.nlm.nih.gov/pubmed/19761357
5. Nair, B. Final report on the safety assessment of benzyl alcohol, benzoic acid, and sodium benzoate. Int J Toxicol 20 Suppl 3, 23‐50 (2001). https://www.ncbi.nlm.nih.gov/pubmed/11766131
6. Hazan, R., Levine, A. & Abeliovich, H. Benzoic acid, a weak organic acid food preservative, exerts specific effects on intracellular membrane trafficking pathways in Saccharomyces cerevisiae. Appl Environ Microbiol 70, 4449‐4457 (2004). https://www.ncbi.nlm.nih.gov/pubmed/15294772
7. Lee, H. S. & Kim, I. H. Salicylic acid peels for the treatment of acne vulgaris in Asian patients. Dermatol Surg 29, 1196-9; discussion 1199 (2003). https://www.ncbi.nlm.nih.gov/pubmed/14725662
8. Grimes, P. E. The safety and efficacy of salicylic acid chemical peels in darker racial-ethnic groups. Dermatol Surg 25, 18-22 (1999). https://www.ncbi.nlm.nih.gov/pubmed/9935087
9. Mahendra Kumar Trivedi, A.B., Dahryn Trivedi, Harish Shettigar, Khemraj Bairwa and Snehasis Jana. Fourier Transform Infrared and Ultraviolet-Visible spectroscopic Characterization of Biofield Treated Salicylic Acid and Sparfloxacin. Natural Products Chemistry & Research 3, 6 (2015). https://www.longdom.org/open-access/fourier-transform-infrared-and-ultravioletvisible-spectroscopiccharacterization-of-biofield-treated-salicylic-acid-and-sparfloxacin-2329-6836-1000186.pdf
10. Uhoda, E. , Pierard-Franchimont, C. & Pierard, G.E. Comedolysis by a lipohydroxyacid formulation in acne-prone subjects. Eur J Dermatol 13, 65-8 (2003). https://www.ncbi.nlm.nih.gov/pubmed/12609785
11. Webster, G.F. Acne vulgaris. BMJ 325, 475-9 (2002). https://www.ncbi.nlm.nih.gov/pubmed/12202330
12. Sehgal, V. Dermatologic Surgery Made Easy (Jaypee Brothers Publishers, 2010). https://books.google.com/books/about/Dermatologic_Surgery_Made_Easy.html?id=bpg3PQAACAAJ

Daniel Kern is the Chief Scientific Officer at Acne.org. This article is the result of Dan’s collaboration with Acne.org’s team of doctors and medical writers.

Is it harmful to the skin?

In the cosmetology industry, there are a huge number of acids that can have one or another effect on the skin of the face. Acids are generally considered to be very popular ingredients in cosmetics, so it is important to understand what effect this or that acid has. Today we decided to talk about benzoic acid, why it is needed, whether it is harmful to the skin and in what products it is used.

What is it?

Benzoic acid is a preservative. It is used in cosmetic formulations because it reduces the growth of bacteria and also increases the shelf life of a cream, scrub, or serum.

Important to know! Drinking benzoic acid in small amounts is completely harmless to your skin.

Origin of benzoic acid

This acid can be either of chemical or vegetable origin. Benzoic acid in nature can be found in raspberries, lingonberries, cranberries. In chemical laboratories, it is usually obtained in the process of oxidation of catalysts and toluene.

Why do we need benzoic acid?

Due to its antibacterial properties, benzoic acid is used in the preparation for oily and problematic skin. In addition, it can be part of the means to lighten skin tone and remove age spots.

Are products containing benzoic acid safe?

Cosmetic products containing benzoic acid are not dangerous for the skin of the face, since it is contained there in an acceptable concentration, accordingly, no skin reactions to acid can occur. It is worth remembering that applying the acid in its pure form to the skin can not only cause an allergic reaction, but also lead to headaches and even effects on the kidneys.

Which benzoic acid products should be used:

Image Skincare VITAL C Anti-Aging Serum

Multifunctional serum with high bioavailability of active ingredients, which allows you to quickly and effectively treat different skin conditions. The richest composition of plant extracts, peptides and oils of plant origin provides the skin with radiance, strengthens capillaries, restores the skin matrix.

For whom?

Any type of dehydrated skin, including oily skin with acne, dull, tired, “smoker’s skin”, age-related changes, post-inflammatory pigmentation, rosacea.

Serum is able to restore dull and dehydrated skin, as well as reduce the visible effects of stress and fatigue. It has a rejuvenating, brightening and anti-inflammatory effect.

Anti-Aging Serum Key Ingredients:

– Mixture of 4 forms of Vitamin C (Tetrahexyldecyl Ascorbate, L-Ascorbic Acid, Magnesium Ascorbyl Phosphate, Sodium Ascorbyl Phosphate) – stable, water and fat soluble forms of Vitamin C, stimulate collagen synthesis I and III types and prevent it from destruction, nourish the skin, have a brightening and antioxidant effect. Protect against photoaging.

– A mixture of 3 essential oils (Mandarin, Orange and Clove) – reduce mimic wrinkles, moisturize and nourish the skin, even out its tone, strengthen capillaries in the dermis, remove toxic substances, improve lymphatic drainage, have an anti-inflammatory effect, improve skin tone.

– A mixture of 2 types of Centella Asiatica extract – Smoothes wrinkles, eliminates dryness and flaking. Refresh the skin. They have a brightening effect, reduce the severity of age spots. Indicated for rosacea. Enhance collagen synthesis, have anti-inflammatory, soothing, healing properties.

– 5 Amino Acid Blend (Taurine, Arginine, Lysine, Leucine, Valine) – Eliminate dull, dry and irritated skin. Slow down the aging process, maintain water balance. Remove toxins, stimulate microcirculation, promote healing, stimulate collagen synthesis, retain moisture in the skin.

Find more richly formulated products for effective face and body care at Image Skincare .

What can benzoyl peroxide do in cosmetics? Beauty educational program in a minute

Content:

1. Benzoyl peroxide: action
2. Properties of benzoyl peroxide
3. Indications for use
4. Precautions
5. Application of benzoyl peroxide
6. Benzoyl peroxide: side effects

Upon contact with the skin, benzoyl peroxide decomposes into benzoic acid and oxygen. Benzoic acid stimulates the process of cell renewal, due to which keratinized scales are removed from the surface of the epidermis, which prevent the proper secretion of sebum.

The basis of the effectiveness of this substance against acne is the destruction of Propionibacterium acnes bacteria, which, as you might guess from the name, provoke rashes on the skin. And it is oxygen that kills them – one of the decomposition products of benzoyl peroxide.

The healing properties of benzoyl peroxide are due to its strong antibacterial action: it inhibits the growth of P. Acnes bacteria and exfoliates the upper layer of the epidermis, preventing the accumulation of fat and dirt in the pores.

With prolonged use, cosmetics with benzoyl peroxide can greatly reduce the number of rashes and prevent the appearance of new ones, and at the same time even out skin tone and relief.

Indications for the use of benzoyl peroxide – acne, seborrhea, excessive sebum secretion, characteristic of oily and combination skin. As a rule, cosmetologists and dermatologists prescribe cosmetic preparations containing this component for people with mild to moderate acne.

Since cosmetics, which include benzoyl peroxide, are freely sold in any Russian pharmacy, many people prescribe it to themselves as a measure to combat rashes.

It is better not to self-medicate – first consult a dermatologist or cosmetologist.

Despite the fact that only cosmetic products with a conditionally safe percentage of benzoyl peroxide are in free circulation in the Russian Federation, it is still worth following some recommendations.

1. Although benzoyl peroxide is not prohibited during pregnancy, it should be used with caution. Dermatologists insist: when pregnancy occurs, the dose should be reduced and such cosmetic products should be applied only pointwise.

2. Like all exfoliating ingredients, benzoyl peroxide increases the skin’s photosensitivity to UVA and UVB rays. When applying cosmetics with this component, protect your skin from the sun with an SPF cream.

3. Many people who have experienced the use of benzoyl peroxide report dry, irritated skin. And it’s true: benzoyl peroxide mercilessly dries the skin, and in combination with salicylic acid, which is effective against acne, it can even turn it into a state of parchment.

But this is exactly the case when beauty requires sacrifice: a period that is unpleasant for the skin can only be endured, the main thing is to intensely moisturize and nourish the skin, and also do not forget about protection from the sun.