What are the indications for benzoyl peroxide use. How does benzoyl peroxide work against acne. What are the potential side effects of benzoyl peroxide. How is benzoyl peroxide administered for optimal results. Are there any contraindications for benzoyl peroxide use.

Understanding Benzoyl Peroxide: An Effective Acne Treatment

Benzoyl peroxide is a widely used medication for treating acne vulgaris, available both over-the-counter and as a prescription. Its effectiveness lies in its ability to combat Cutibacterium acnes (C. acnes), the bacteria primarily responsible for acne development. Unlike other topical antibiotics, benzoyl peroxide has not shown signs of developing drug resistance, making it a reliable long-term treatment option.

How does benzoyl peroxide work against acne? The medication exhibits bactericidal effects by converting to benzoic acid upon skin absorption. This process releases active free-radical oxygen species, which oxidize bacterial proteins, effectively reducing P. acnes populations in hair follicles by up to 98% after two weeks of daily application.

The Multifaceted Benefits of Benzoyl Peroxide

While primarily known for its acne-fighting properties, benzoyl peroxide offers additional benefits:

• Mild sebostatic effects, helping to regulate oil production
• Keratolytic activity, aiding in the treatment of comedonal acne
• Reduction of free fatty acids on the skin
• Stimulation of healthy granulation tissue in cutaneous ulcers

These diverse effects contribute to benzoyl peroxide’s versatility in treating various skin conditions beyond acne vulgaris.

Off-Label Uses: Expanding the Scope of Benzoyl Peroxide

While primarily indicated for acne treatment, benzoyl peroxide has shown promise in addressing several other skin conditions:

• Inflammatory forms of rosacea
• Various types of folliculitis, including gram-negative and drug-induced
• Pseudo-folliculitis barbae
• Progressive macular hypomelanosis
• Pressure ulcers
• Perforating diseases
• Pitted keratolysis

These off-label uses highlight the potential of benzoyl peroxide as a versatile topical treatment for a range of dermatological concerns.

Administration and Formulations: Tailoring Treatment to Individual Needs

How is benzoyl peroxide administered for optimal results? The medication is available in various concentrations and formulations to suit different skin types and treatment needs:

• Concentrations: 2.5%, 5%, and 10%
• Formulations: Lotions, creams, gels, foams, solutions, cleansing bars, cleansing lotions, cloths, pads, masks, and shaving creams

Application frequency varies depending on the specific product:

• Cleansing bars and washes: 1-3 times daily
• Masks: Once weekly for 15-25 minutes
• Combination products with antibiotics: Twice daily
• Combination products with adapalene: Once daily

Studies have shown that combination products containing benzoyl peroxide with topical antibiotics or adapalene are more effective in treating acne vulgaris than either medication used alone.

Potential Side Effects and Precautions

What are the potential side effects of benzoyl peroxide? While generally well-tolerated, users should be aware of possible adverse effects:

• Bleaching of fabrics and hair
• Mild dryness, erythema, and scaling (especially at higher concentrations)
• Contact dermatitis in a small percentage of users

If marked erythema and irritation occur at the treatment site, discontinuation of benzoyl peroxide is recommended. Users should also exercise caution to avoid contact with eyes, nose, mouth, and mucous membranes.

Contraindications and Precautions: Ensuring Safe Use

Are there any contraindications for benzoyl peroxide use? Certain individuals should avoid or use benzoyl peroxide with caution:

• Those with a known hypersensitivity to benzoyl peroxide
• Individuals allergic to cinnamon or other benzoic acid derivatives (due to potential cross-reactivity)
• Patients with sensitive skin or a history of allergic reactions to topical treatments

It’s essential for healthcare providers to thoroughly assess a patient’s medical history and potential risk factors before recommending benzoyl peroxide treatment.

Combining Benzoyl Peroxide with Other Treatments: Maximizing Efficacy

To enhance the effectiveness of acne treatment, benzoyl peroxide is often used in combination with other topical or systemic medications. Common combination therapies include:

• Benzoyl peroxide + topical antibiotics (e.g., erythromycin, clindamycin)
• Benzoyl peroxide + adapalene
• Benzoyl peroxide + oral antibiotics

These combinations can provide synergistic effects, targeting multiple aspects of acne pathogenesis and potentially reducing the risk of antibiotic resistance.

Benefits of Combination Therapy

Why consider combination therapy with benzoyl peroxide? Combining treatments can offer several advantages:

• Enhanced efficacy compared to monotherapy
• Reduced risk of bacterial resistance
• Faster onset of action
• Potential for lower doses of individual medications, minimizing side effects

However, it’s crucial to consult a healthcare professional before initiating any combination therapy to ensure safety and appropriateness for individual cases.

Long-Term Use and Maintenance: Sustaining Clear Skin

For many individuals with acne-prone skin, long-term use of benzoyl peroxide may be necessary to maintain clear skin and prevent breakouts. How can patients ensure safe and effective long-term use?

• Regular follow-ups with a dermatologist or healthcare provider
• Gradual adjustment of concentration and frequency as needed
• Incorporation of moisturizers to combat potential dryness
• Consistent use of sun protection, as benzoyl peroxide can increase sun sensitivity

Long-term users should be vigilant for any changes in skin response or the development of new symptoms, reporting these to their healthcare provider promptly.

Monitoring Treatment Progress

To ensure optimal results and detect any potential issues early, regular monitoring of benzoyl peroxide treatment is essential. This may include:

• Periodic skin assessments by a healthcare professional
• Patient-reported outcomes on acne severity and quality of life
• Evaluation of treatment adherence and any barriers to consistent use
• Assessment of any side effects or tolerability issues

By closely monitoring treatment progress, healthcare providers can make timely adjustments to the treatment plan, ensuring the best possible outcomes for patients using benzoyl peroxide.

Future Directions: Innovations in Benzoyl Peroxide Formulations

As research in dermatology continues to advance, new developments in benzoyl peroxide formulations and delivery systems are emerging. These innovations aim to enhance efficacy, improve tolerability, and expand the range of applications for this versatile medication.

Emerging Technologies

What are some promising developments in benzoyl peroxide technology? Researchers are exploring several avenues:

• Nanoparticle formulations for enhanced skin penetration
• Time-release systems for prolonged action and reduced irritation
• Combination products with novel ingredients for synergistic effects
• Customizable formulations tailored to individual skin types and concerns

These advancements may lead to more personalized and effective acne treatments, potentially expanding the role of benzoyl peroxide in dermatological care.

Expanding Applications

Beyond acne treatment, ongoing research is investigating the potential of benzoyl peroxide in addressing other skin conditions. Areas of interest include:

• Wound healing and scar prevention
• Treatment of fungal skin infections
• Management of chronic skin conditions such as seborrheic dermatitis
• Combination therapies for complex dermatological disorders

As our understanding of skin biology and the mechanisms of benzoyl peroxide action deepens, new therapeutic possibilities may emerge, further solidifying its place in the dermatologist’s toolkit.

Patient Education: Empowering Effective Use of Benzoyl Peroxide

Successful treatment with benzoyl peroxide relies heavily on proper patient education and adherence to treatment regimens. Healthcare providers play a crucial role in ensuring patients understand how to use the medication effectively and safely.

Key Points for Patient Education

What essential information should be conveyed to patients using benzoyl peroxide? Important points include:

• Proper application techniques and frequency
• Potential side effects and how to manage them
• The importance of sun protection during treatment
• Realistic expectations for treatment outcomes and timeline
• Strategies for incorporating benzoyl peroxide into a comprehensive skincare routine

By providing clear, comprehensive education, healthcare providers can empower patients to use benzoyl peroxide effectively and maximize treatment benefits.

Addressing Common Concerns

Patients often have questions and concerns about using benzoyl peroxide. Addressing these proactively can improve treatment adherence and outcomes. Common concerns include:

• Initial skin irritation or dryness
• Bleaching effects on clothing and bedding
• Compatibility with other skincare products
• Long-term safety of continued use

Providing clear, evidence-based information on these topics can help alleviate patient concerns and promote confident, consistent use of benzoyl peroxide.

The Role of Benzoyl Peroxide in Comprehensive Acne Management

While benzoyl peroxide is a powerful tool in acne treatment, it’s important to view it as part of a comprehensive approach to acne management. Effective acne control often requires a multifaceted strategy that addresses various aspects of skin health and acne pathogenesis.

Integrating Benzoyl Peroxide into a Holistic Treatment Plan

How can benzoyl peroxide be incorporated into a comprehensive acne management plan? Consider the following elements:

• Gentle cleansing routines to remove excess oil and debris
• Non-comedogenic moisturizers to maintain skin hydration
• Topical retinoids for long-term pore regulation and anti-aging benefits
• Oral medications for severe or resistant acne cases
• Dietary and lifestyle modifications to support overall skin health

By combining benzoyl peroxide with other evidence-based treatments and lifestyle interventions, patients can achieve optimal acne control and improved skin health.

Personalized Treatment Approaches

Recognizing that acne is a complex condition with various contributing factors, personalized treatment approaches are increasingly important. Factors to consider when tailoring treatment plans include:

• Acne type and severity
• Skin type and sensitivity
• Patient preferences and lifestyle
• Previous treatment history and response
• Presence of concurrent skin conditions

By carefully assessing these factors and adjusting treatment plans accordingly, healthcare providers can optimize the use of benzoyl peroxide and other acne therapies for each individual patient.

Conclusion: The Enduring Value of Benzoyl Peroxide in Dermatology

Benzoyl peroxide remains a cornerstone in the treatment of acne vulgaris and has shown promise in addressing various other skin conditions. Its unique mechanism of action, coupled with a low risk of bacterial resistance, makes it a valuable tool in the dermatologist’s arsenal.

As research continues to unveil new applications and formulations, benzoyl peroxide is likely to maintain its relevance in dermatological care. By understanding its proper use, potential side effects, and role in comprehensive skin health management, both healthcare providers and patients can harness the full potential of this versatile medication.

The future of benzoyl peroxide in dermatology looks promising, with ongoing innovations poised to enhance its efficacy and expand its therapeutic reach. As we continue to deepen our understanding of skin biology and refine our treatment approaches, benzoyl peroxide will undoubtedly play a crucial role in advancing dermatological care and improving patient outcomes.

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

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• 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.