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

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 as a prescription. Its primary function is to combat Cutibacterium acnes (C. acnes), the bacteria responsible for acne development. This versatile compound not only fights bacteria but also offers mild sebostatic and keratolytic effects, making it a cornerstone in acne treatment regimens.

How does benzoyl peroxide work against acne? The mechanism is multifaceted:

1. It converts to benzoic acid upon skin absorption
2. Releases active free-radical oxygen species
3. Oxidizes bacterial proteins
4. Reduces lipids and free fatty acids
5. Decreases P. acnes population in hair follicles

Studies have shown that daily application of 10% benzoyl peroxide for two weeks can reduce P. acnes in hair follicles by an impressive 98% and free fatty acids by 50%. These results are comparable to those achieved after four weeks of antibiotic therapy, highlighting the efficacy of benzoyl peroxide in acne management.

Beyond Acne: Exploring Off-Label Uses of Benzoyl Peroxide

While primarily known for its acne-fighting properties, benzoyl peroxide has found utility in treating various other skin conditions. What are the off-label uses of benzoyl peroxide? Healthcare professionals have explored its potential in managing:

• Inflammatory forms of rosacea
• Folliculitis (including gram-negative, non-infectious, and drug-induced varieties)
• 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 expanded range of applications underscores the versatility of benzoyl peroxide in dermatological treatments.

Optimal Administration: Maximizing Benzoyl Peroxide’s Efficacy

How is benzoyl peroxide administered for optimal results? The key lies in understanding the various formulations and their specific instructions:

• Concentrations: Available in 2.5%, 5%, and 10% strengths
• Formulations: Lotions, creams, gels, foams, solutions, cleansing bars, cleansing lotions, cloths, pads, masks, and shaving creams
• Application frequency: Varies based on the product type

For instance, cleansing bars and washes are typically used one to three times daily, while masks are applied as a thin layer once a week for 15 to 25 minutes. Combination products with antibiotics like erythromycin or clindamycin are usually applied twice daily, whereas those with adapalene are used once daily.

Research has demonstrated that combination products containing benzoyl peroxide with topical antibiotics or adapalene yield superior results compared to monotherapy. This synergistic approach enhances the overall efficacy of acne treatment regimens.

Navigating Potential Side Effects: What to Watch For

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

• Bleaching effect on colored fabrics and hair
• Mild dryness, erythema, and scaling (especially at higher concentrations)
• Rare cases of contact dermatitis

The bleaching quality is the most common adverse effect, necessitating caution when applying the product near clothing or hair. At higher concentrations, some users may experience mild skin irritation. In rare instances, patients may develop contact dermatitis, characterized by marked erythema and irritation at the treatment site. If such symptoms occur, it’s advisable to discontinue use and consult a healthcare professional.

Safety First: Contraindications and Precautions

Are there any contraindications for benzoyl peroxide use? While generally safe, certain individuals should exercise caution:

• Those with known hypersensitivity to benzoyl peroxide
• Patients allergic to cinnamon and other benzoic acid derivatives (due to potential cross-reactivity)

It’s crucial to note that benzoyl peroxide is not indicated for use around sensitive areas such as the eyes, nose, mouth, or mucous membranes. Patients should always follow the prescribed or recommended application instructions to minimize the risk of adverse effects.

Benzoyl Peroxide in Clinical Practice: Improving Patient Outcomes

How can healthcare professionals optimize the use of benzoyl peroxide in clinical settings? A multifaceted approach is key:

1. Accurate identification of suitable candidates for benzoyl peroxide treatment
2. Comprehensive patient education on proper application techniques
3. Regular monitoring for potential side effects or adverse reactions
4. Consideration of combination therapies for enhanced efficacy
5. Ongoing assessment of treatment response and adjustment as needed

By implementing these strategies, healthcare providers can maximize the benefits of benzoyl peroxide while minimizing potential risks. This approach not only improves individual patient outcomes but also contributes to the overall advancement of acne management protocols.

The Future of Benzoyl Peroxide: Research and Innovations

What does the future hold for benzoyl peroxide in dermatological treatments? Ongoing research continues to explore new applications and formulations:

• Novel delivery systems for enhanced skin penetration
• Combination therapies with emerging acne treatments
• Exploration of its potential in managing other skin conditions
• Development of formulations with reduced irritation potential

As our understanding of skin biology and drug delivery mechanisms advances, we can anticipate further refinements in benzoyl peroxide-based treatments. These innovations may lead to more targeted, effective, and well-tolerated therapies for a broader range of dermatological conditions.

Benzoyl Peroxide and Antibiotic Resistance: A Unique Advantage

In the era of increasing antibiotic resistance, benzoyl peroxide offers a distinct advantage. Unlike topical antibiotics, no evidence of drug resistance has been observed with long-term benzoyl peroxide use. This characteristic makes it a valuable tool in the dermatologist’s arsenal, particularly for managing chronic acne cases where antibiotic resistance is a concern.

How does benzoyl peroxide maintain its efficacy over time? Its mechanism of action, which involves the release of free-radical oxygen species, provides a non-specific antimicrobial effect that bacteria find difficult to adapt to. This property not only ensures continued effectiveness but also supports its use in combination with antibiotics to potentially prevent or delay the development of resistance.

Patient Education: Key to Successful Benzoyl Peroxide Treatment

Effective use of benzoyl peroxide hinges on proper patient education. Healthcare providers play a crucial role in ensuring patients understand:

• Correct application techniques
• Potential side effects and how to manage them
• The importance of consistency in treatment
• Precautions to prevent staining of clothing and bedding
• The need for patience, as results may take several weeks to become apparent

By empowering patients with this knowledge, healthcare professionals can enhance treatment adherence and overall satisfaction with benzoyl peroxide therapy.

Benzoyl Peroxide in Special Populations

How should benzoyl peroxide be used in special populations, such as pregnant women or individuals with sensitive skin? While generally considered safe, special considerations may apply:

• Pregnancy: Classified as FDA Category C, use should be discussed with a healthcare provider
• Sensitive skin: Lower concentrations or less frequent applications may be advisable
• Pediatric patients: Care should be taken to avoid overuse or application to large body areas
• Elderly patients: May require moisturizing formulations due to age-related skin changes

Tailoring benzoyl peroxide use to individual patient needs and characteristics is essential for maximizing benefits while minimizing potential risks.

Integrating Benzoyl Peroxide into Comprehensive Skincare Regimens

How can benzoyl peroxide be effectively incorporated into a broader skincare routine? Consider the following strategies:

1. Use gentle, non-comedogenic cleansers before application
2. Apply benzoyl peroxide to clean, dry skin
3. Allow the product to fully absorb before applying moisturizers or other skincare products
4. Use sun protection, as benzoyl peroxide may increase sun sensitivity
5. Consider alternating benzoyl peroxide with other acne treatments to minimize irritation

By thoughtfully integrating benzoyl peroxide into a comprehensive skincare regimen, patients can maximize its benefits while maintaining overall skin health.

The Role of Benzoyl Peroxide in Managing Hormonal Acne

Can benzoyl peroxide effectively address hormonal acne? While hormonal acne often requires a multifaceted approach, benzoyl peroxide can play a valuable role:

• Reduces inflammation associated with hormonal breakouts
• Helps prevent the formation of new acne lesions
• Can be used in conjunction with hormonal therapies for enhanced results
• Provides a non-hormonal option for patients who cannot use systemic hormonal treatments

When combined with other targeted treatments, benzoyl peroxide can significantly improve outcomes for patients struggling with hormonal acne.

Environmental Considerations: Benzoyl Peroxide and Sustainability

As environmental concerns grow, what are the ecological implications of benzoyl peroxide use? Consider the following aspects:

• Potential impact on aquatic ecosystems when washed off
• Importance of proper disposal of unused product
• Development of more environmentally friendly formulations
• Exploration of natural alternatives with similar efficacy

As the skincare industry moves towards greater sustainability, we may see innovations in benzoyl peroxide formulations and application methods that address these environmental concerns while maintaining therapeutic efficacy.

Benzoyl Peroxide in the Digital Age: Telemedicine and Remote Monitoring

How has the rise of telemedicine impacted benzoyl peroxide prescribing and monitoring? The digital revolution in healthcare has brought new opportunities and challenges:

• Remote consultations for prescribing and follow-up
• Digital tools for tracking treatment progress and side effects
• AI-powered skin analysis for personalized treatment recommendations
• Online platforms for patient education and support

These technological advancements are reshaping how benzoyl peroxide treatments are prescribed, monitored, and optimized, potentially improving accessibility and outcomes for patients worldwide.

The Economic Impact of Benzoyl Peroxide in Acne Management

What is the economic significance of benzoyl peroxide in the broader context of acne treatment? Consider these factors:

• Cost-effectiveness compared to prescription antibiotics
• Potential reduction in long-term healthcare costs by preventing severe acne
• Impact on productivity and quality of life for acne sufferers
• Market dynamics influencing product availability and pricing

Understanding the economic implications of benzoyl peroxide use can inform policy decisions and healthcare strategies aimed at optimizing acne management on a population level.

Benzoyl Peroxide and Skin Microbiome: Striking a Balance

How does benzoyl peroxide impact the skin’s microbiome, and what are the implications for long-term skin health? This area of research is gaining increasing attention:

• Effects on beneficial skin bacteria
• Potential for microbiome restoration strategies post-treatment
• Development of probiotic-enhanced benzoyl peroxide formulations
• Implications for skin barrier function and overall skin health

As our understanding of the skin microbiome grows, we may see more nuanced approaches to benzoyl peroxide use that aim to maintain microbial balance while effectively treating acne.

Cultural Perspectives on Benzoyl Peroxide and Skincare

How do cultural factors influence the perception and use of benzoyl peroxide in different parts of the world? Consider these aspects:

• Varying beauty standards and attitudes towards acne
• Traditional medicine practices that may complement or conflict with benzoyl peroxide use
• Cultural preferences for natural versus synthetic skincare ingredients
• Influence of social media and global beauty trends on treatment choices

Understanding these cultural nuances can help healthcare providers and skincare companies tailor their approaches to better serve diverse patient populations.

Benzoyl Peroxide in Professional Skincare: Beyond OTC Use

How is benzoyl peroxide utilized in professional skincare settings? Its applications extend beyond over-the-counter products:

• Higher concentration formulations for in-office treatments
• Incorporation into chemical peels and other professional procedures
• Use in preparation for other acne treatments, such as laser therapy
• Custom compounded formulations for individual patient needs

These professional applications showcase the versatility of benzoyl peroxide and its integral role in comprehensive acne management strategies.

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.