What is benzoyl peroxide and how can it help with acne? Discover the benefits, precautions, and proper ways to use this effective acne treatment.

Benzoyl Peroxide: A Powerful Acne-Fighting Agent

Benzoyl peroxide (BPO) is a chemical compound that has been used in acne treatment formulas for over 80 years. It is an effective and widely-used ingredient in various acne medications and skincare products. Benzoyl peroxide works by serving as a bleaching and peeling agent, as well as having antimicrobial properties that help fight the acne-causing bacteria Propionibacterium acnes (P. acnes).

Benefits of Using Benzoyl Peroxide for Acne

Benzoyl peroxide offers several key benefits for those struggling with blemished and impure skin:

• It helps to unclog pores and reduce blockages by peeling away dead skin cells, similar to salicylic acid or resorcinol.
• It effectively kills the P. acnes bacteria that contributes to acne breakouts.
• It has anti-inflammatory properties that can help reduce the pain and discomfort associated with acne lesions.
• It helps eliminate excess oils and fatty acids in the skin.

Potential Side Effects and Precautions

While benzoyl peroxide is an effective acne treatment, it is important to be aware of its potential side effects and take proper precautions when using it:

1. Dryness and irritation: Benzoyl peroxide can be very drying and irritating, especially during the initial weeks of use. This may result in dryness, redness, itching, flaking, or mild peeling. This is temporary and will subside as your skin adjusts.
2. Avoid the eye area and lower neck: Do not apply benzoyl peroxide to the delicate skin around the eyes or on the lower neck, as it can cause over-drying and irritation.
3. Avoid using with traditional moisturizers: Typical moisturizers can interfere with the efficacy of benzoyl peroxide and cause the product to travel into the eye area. Instead, use a hydrating gel or serum.
4. Beware of eyelid irritation: Allow benzoyl peroxide to fully dry before going to bed, and change your pillowcase more frequently to prevent irritation.
5. Protect sensitive areas: The smile line area is particularly sensitive and may be the first place you experience dryness and irritation. You can apply a thin layer of a soothing balm to this area for a few days to provide protection.
6. Avoid use during exercise or sweating: Do not wear benzoyl peroxide when you expect to perspire, as it can further irritate the skin.
7. Bleaching effect: Benzoyl peroxide can bleach fabrics, so be sure to wear white clothing and use white washcloths and pillowcases when using the product.
8. Allergic reactions: Allergies to benzoyl peroxide, while rare, can occur. Signs of an allergic reaction include itching, swelling, or a rash similar to poison ivy. If this happens, discontinue use and contact your healthcare provider.

Proper Application and Usage

To get the most effective results from benzoyl peroxide, it’s important to use it correctly:

• Apply it to the entire acne-prone area, not just spot treatments. This helps prevent future breakouts.
• Use it consistently, every day, without skipping. Inconsistent use can allow acne to return.
• Wash your hands thoroughly after each application to avoid bleaching towels or other fabrics.

Dealing with the Dryness and Irritation

The initial dryness and irritation caused by benzoyl peroxide can be challenging, but pushing through this phase is key to achieving the best results. Those who are able to tolerate the temporary discomfort often see the fastest improvements in their acne. However, if the dryness becomes too uncomfortable or you have a darker skin tone, there are some tips that can help:

1. Introduce the product gradually, starting with a lower concentration or using it every other day.
2. Use a hydrating serum or gel-based moisturizer, avoiding traditional creams that can interfere with the benzoyl peroxide.
3. Apply a thin layer of a soothing balm or ointment to particularly dry or sensitive areas, like the smile lines.
4. Exfoliate gently to help remove dead skin cells and improve the absorption of benzoyl peroxide.
5. Consult with a skincare professional for personalized guidance on managing the dryness and irritation.

Consistency is Key for Long-Term Acne Control

One of the most important things to remember when using benzoyl peroxide for acne is the importance of consistent and diligent use. Skipping applications or only spot-treating can allow acne to return and prevent you from achieving the clear, blemish-free skin you desire. By using benzoyl peroxide as directed, over the entire acne-prone area, every day, you’ll be on the path to long-term acne control and a clearer complexion.

Getting Support Along the Way

Navigating the process of using benzoyl peroxide and other acne treatments can be challenging, but you don’t have to do it alone. Reach out to a team of experienced skincare professionals, like the estheticians at [Company Name], for personalized guidance and support throughout your acne treatment journey. They can offer helpful tips, answer your questions, and provide the resources and encouragement you need to achieve your skin health goals.

How To Successfully Use Benzoyl Peroxide

Acne is one of the most common skin challenges in the U.S. and it’s not just limited to teenagers. In fact, it impacts all ages, races, and genders. Nearly 60 million Americans have active acne and 20 million are at risk of developing scar tissue as a result.

What is Benzoyl Peroxide?

Benzoyl peroxide (BPO) is a chemical in the organic peroxide family that has been used in acne treatment formulas for more than 80 years. It works as a bleaching and peeling agent, is antimicrobial, increases cell turnover, reduces bacterial count, clears up existing acne, and prevents future breakouts.

Benzoyl peroxide is a white or off-white water-soluble crystalline powder that offers the following benefits for blemished and impure skin:

• It peels skin like salicylic or resorcinol, reducing blockages.
• It kills the bacterium Propionibacterium acnes (P.acnes).
• It has anti-inflammatory properties that reduce pain and discomfort associated with many lesions.
• It eliminates fatty acids and oils in the skin.

Things You Should Know About Using Benzoyl Peroxide & Acne Med:

Expect to be a bit dry!

Benzoyl peroxide can be extremely irritating and drying. During the initial weeks, you may experience some dryness, redness, itching, flaking, tightness, or mild peeling. This is temporary and will subside as your skin adapts. Those who can push through the initial dryness and light flaking get the fastest results. However, if you are uncomfortably dry or have a darker skin tone, let us know. We can offer some helpful tips for getting through the dry phase.

Avoid eye area and lower neck

Do not use benzoyl peroxide on your neck or eye area as the tissue is too delicate and it will over dry and irritate the skin.

No eye cream in the PM

Do not use eye cream or moisturizer around the eyes or neck because the benzoyl peroxide will migrate through the cream and cause irritation and possible swelling.

Avoid using traditional moisturizers

Traditional moisturizers cannot be used under or over benzoyl peroxide. They interfere with efficacy and cause the acne med to travel into the eye area. Those that need hydration in the PM should use a hydrating gel or serum.

Avoid eye irritation

Allow benzoyl peroxide to dry before going to bed. If your eyelids get irritated, try changing your pillowcase more often. When you are wearing acne med at night, it will get on the pillowcase.

Smile lines

This area tends to be the most sensitive area on the face and will be the first place you see irritation and dryness. You can put a very thin layer of Rhonda Allison Pro Salve on this area to protect it for a few days and then resume product regular product use.

Working out? Remove benzoyl peroxide

Do not wear benzoyl peroxide when you expect to perspire. If you plan to exercise, engage in physical labor, or be outside under the hot sun, wash it off first or it will irritate your skin.

Will bleach fabric

Benzoyl peroxide will bleach fabric, so we suggest wearing a white shirt when using it. Also, use a white washcloth when removing the product from your skin. Use white pillowcases when you start wearing benzoyl peroxide overnight. Make sure to wash your hands with soap following each application to avoid bleaching towels.

Allergic reaction

Allergies to benzoyl peroxide are rare but do occur occasionally. Dry skin does not constitute an allergic reaction. An allergy is characterized by itching, swelling, or burning associated with a rash similar to a mild case of poison ivy dermatitis. If you are experiencing unusual irritation or an allergic reaction occurs, stop using Acne Med and contact us immediately.

Diligence pays off

If you skip a day or two or only spot treat, this break in your treatment gives a chance for acne to form. You will never get clear if you skip your home care treatment plan.

Use over the entire acne-prone area

While spot treating can be effective for those who are mildly blemish-prone, those with inflamed acne must use benzoyl peroxide serum over the entire acne-prone area, every day. This is what will help prevent future breakouts.

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FDA Drug Safety Communication: FDA warns of rare but serious hypersensitivity reactions with certain over-the-counter topical acne products

en Español

View and print full Drug Safety Communication (PDF – 43KB)

• Safety Announcement
• Facts about over-the-counter topical acne products
• Additional Information for Consumers
• Additional Information for Health Care Professionals
• Data Summary

Safety Announcement

[6-25-2014] The U.S. Food and Drug Administration (FDA) is warning that certain over-the-counter (OTC) topical acne products can cause rare but serious and potentially life-threatening allergic reactions or severe irritation.   Consumers should stop using their topical acne product and seek emergency medical attention immediately if they experience hypersensitivity reactions such as throat tightness; difficulty breathing; feeling faint; or swelling of the eyes, face, lips, or tongue.  Consumers should also stop using the product if they develop hives or itching.
 

These serious hypersensitivity reactions differ from the local skin irritation that may occur at the product application site, such as redness, burning, dryness, itching, peeling, or slight swelling, that are already included in the Drug Facts labels.   
 

Based on the information reported to FDA, we cannot determine if the serious hypersensitivity reactions were triggered by the acne products’ active ingredients, benzoyl peroxide or salicylic acid, the inactive ingredients, or by a combination of both.  The hypersensitivity reactions may occur within minutes to a day or longer after product use.  The OTC topical acne products of concern are marketed under various brand names such as Proactiv, Neutrogena, MaxClarity, Oxy, Ambi, Aveeno, Clean & Clear, and as store brands.   They are available as gels, lotions, face washes, solutions, cleansing pads, toners, face scrubs, and other products.
 

Manufacturers of OTC topical acne drug products have the option to add label directions for sensitivity testing for new users of their products (see Guidance for Industry).  We encourage new users of OTC topical acne drug products to follow these directions.  We are also encouraging manufacturers to add these directions to all product labels, to reduce the risk of serious hypersensitivity reactions.  According to these directions, before using an OTC topical acne product for the first time, consumers should apply a small amount to one or two small affected areas of the skin for 3 days.  If no discomfort occurs, then the product can be used according to the directions on the Drug Facts label.  Consumers should avoid using an OTC topical acne product again if they have previously experienced a hypersensitivity reaction with its use.
 

We are continuing to monitor and evaluate this safety issue, and will work with manufacturers regarding any future label changes that would address the risk of severe hypersensitivity reactions.  

Facts about over-the-counter topical acne products

• Some products contain the active ingredients benzoyl peroxide or salicylic acid.
• Sold under various brand names such as Proactiv, Neutrogena, MaxClarity, Oxy, Ambi, Aveeno, Clean & Clear, and as store brands.
• Available as gels, lotions, face washes, solutions, cleansing pads, toners, face scrubs, and other products.

Additional Information for Consumers  

• Rare but serious hypersensitivity reactions have been reported with the use of certain over-the-counter (OTC) topical acne products.  
• Based on adverse events reported to FDA, it is not possible to determine if these reactions were triggered by the active ingredients benzoyl peroxide or salicylic acid, the inactive ingredients, or a combination of both. 
• Stop using the product and seek emergency medical attention immediately if you develop signs and symptoms of a serious hypersensitivity reaction such as:
  • throat tightness
  • difficulty breathing
  • feeling faint
  • swelling of the eyes, face, lips, or tongue
• Also stop using the product if you develop hives or itching of the face or body.
• Do not use an OTC topical acne product again if you have previously experienced a serious hypersensitivity reaction from it.
• Before using an OTC topical acne drug product for the first time, apply a small amount to one or two small affected areas for 3 days to make sure you don’t develop any hypersensitivity symptoms.  If no discomfort occurs, follow the directions on the Drug Facts label.
• Talk to a health care professional if you have any concerns about using OTC topical acne products.  Questions you might ask include:
  • Is an OTC topical acne product right to treat my acne?
  • Are there other products that you can recommend?
• Report side effects from OTC topical acne products to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of this page.

Additional Information for Health Care Professionals  

• Rare but serious hypersensitivity reactions have been reported with the use of certain over-the-counter (OTC) topical acne products.   Based on adverse events reported to FDA, it is not possible to determine if these reactions were triggered by the active ingredients benzoyl peroxide or salicylic acid, the inactive ingredients, or a combination of both. 
• When recommending OTC topical acne products to consumers, alert them about symptoms of serious hypersensitivity reactions such as skin or mucosal changes and, particularly, about concomitant respiratory or cardiovascular changes such as dyspnea, hypotension, or syncope suggestive of anaphylaxis. 
• Advise consumers to stop using the product if a hypersensitivity reaction occurs and to seek emergency medical attention immediately if they develop symptoms suggestive of anaphylaxis.
• Advise consumers using an OTC topical acne drug product for the first time to apply a small amount to one or two small affected areas for 3 days to make sure they don’t develop any hypersensitivity symptoms.  If no discomfort occurs, they can follow the directions on the Drug Facts label.
• Be aware that some topical prescription acne drug products also contain label warnings about allergy, including anaphylaxis.
• Report adverse events involving OTC topical acne products to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of this page.

Data Summary 

A search of the FDA Adverse Event Reporting System (FAERS) database from 1969 through January 28, 2013 identified 131 cases of hypersensitivity reactions with serious outcomes associated with over-the-counter topical acne drug products containing benzoyl peroxide or salicylic acid.  The majority of the cases were reported since 2012.  Approximately 86 percent (n=113) of the patients were female, and the average patient age was 32 years (range 11-78 years). 

The reported adverse reactions ranged from application site reactions (e.g., skin irritation, burning sensation, erythema, and dermatitis) to swelling of the eyes, lips, tongue, or face; throat tightness; and shortness of breath.   There were no fatalities; however, 44 percent (n=58) of the cases reported that hospitalization was required.  Of the 131 cases, 38 percent (n=50) were categorized as anaphylactic hypersensitivity based on the presence of compromised respiratory or cardiovascular function in addition to skin or mucosal involvement (e.g., facial swelling, hives, angioedema, pruritus, flushing).  The other 81 cases were categorized as non-anaphylactic hypersensitivity based on the presence of severe, isolated skin or mucosal involvement without associated respiratory or cardiovascular changes.  Approximately 42 percent (n=55) of the 131 hypersensitivity events occurred within minutes to 24 hours of product use.  Approximately 43 percent (n=56) of the patients reported discontinuing use of the suspected product.  Of the 56 patients who reported discontinuing product use, 73 percent (n=41) experienced some degree of recovery from their symptoms once the drug was discontinued; final outcomes were not provided in the remaining cases.   In addition, four patients reported a reappearance of their hypersensitivity reaction once the product was reintroduced.

Related Information

• Topical Acne Drug Products for Over-the-Counter Human Use–Revision of Labeling and Classification of Benzoyl Peroxide as Safe and Effective
• Over-the-counter (OTC) Topical Acne Products
• Topical Acne Products Can Cause Dangerous Side Effects
• Comunicado de la FDA sobre la seguridad de los medicamentos: FDA advierte sobre reacciones poco frecuentes pero serias de hipersensibilidad a ciertos productos para el acné de uso tópico y venta libre

Safety Information

• Reporting Serious Problems to FDA

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 not banned for use during pregnancy, benzoyl peroxide 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 bring it to the 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.

4. When using cosmetics with benzoyl peroxide, add a good nourishing cream to your skin care routine, as this substance destroys the hydrolipidic mantle of the skin, which needs to be restored and strengthened.

Apply cosmetics with benzoyl peroxide once a day is sufficient. This should be done in the evening on dry, cleansed skin, avoiding the area around the eyes. The most effective will be the use of the course – for an obvious and lasting result, three months of use will be enough.

The main side effect in this case is burning and dryness, which can be easily corrected by correcting the skin care regimen. Add more moisturizing and nourishing products to your beauty routine: masks, creams and serums.

In extremely rare cases, an allergy to benzoyl peroxide may occur. If you notice a burning sensation, excessive redness of the skin and other atypical reactions, contact your doctor immediately.

Topical application of benzoyl peroxide for acne treatment

Review question

We reviewed the evidence for the efficacy and safety of topical benzoyl peroxide (BPO), alone or in combination therapy. Eligible comparisons included placebo (an identical but inactive agent), no treatment, or other active (medical) topical treatments for acne (used as mono- or combination therapy, but not containing BPO) (evidence current to February 2019of the year).

The primary outcomes of interest for this review were improvement in acne (as assessed by participants) or withdrawal from the study due to any side effects. More generally, we also looked at the percentage of participants who experienced any side effects during the entire trial.

Relevance

As a common skin disease, acne vulgaris affects the physical, psychological and social well-being of millions of adolescents and young adults. A wide range of treatments for acne vulgaris are available, and topical BPO has been recommended as a priority therapy, either alone or in combination with other topical or oral treatments, depending on the severity of acne. However, the benefits and harms of BPO have yet to be assessed.

Study profile

We included 120 studies (29,592 people were randomized in 116 trials; the number of randomized participants was unclear in four trials). In our search, we found studies that evaluated different concentrations of BPO, BPO delivered in different ways, or BPO used alone or with other treatments that may or may not be considered primary treatment. These studies compared treatment with different BPO concentrations, BPO formulations, placebo, no treatment, or other medicinal products used in mono- or combination therapy.

Most studies included men and women with mild to moderate acne; only 67% of the studies reported the age of the participants, which ranged from 18 to 30 years. In nearly two-thirds of the trials, participants were treated for more than eight weeks. The industry provided financial support for about two-fifths of the trials, and more than half of the trials did not report funding sources. Few studies reported where they were conducted, but included hospitals, medical centers, national medical institutes, clinics, medical departments, and general practitioners.

Main results

We found low-certainty evidence to suggest that long-term (i.e. more than eight weeks) use of BPO may increase treatment success (as measured by participants) compared to placebo or no use of BPO (three studies) however, there may be little or no difference when comparing BPO with adapalene (five studies) or clindamycin (one study). This outcome was not reported in studies comparing BPO with erythromycin or salicylic acid.

Long-term use of BPO may increase the chance of treatment interruption compared with placebo or no treatment (24 studies), with redness, itching, and burning of the skin being the most common causes (low-certainty evidence). When comparing the medium- and long-term use of BPO with adapalene (11 studies), clindamycin (8 studies), erythromycin (one study), or salicylic acid (one study), we found only very low-certainty evidence, meaning that although differences between these groups in the probability of dropping out of the study may be small or non-existent, we are not sure about the results. It should be noted that the withdrawal of participants from the study may be due to issues related to the acceptability of treatment (dermatitis, rash, facial swelling, sensitivity), and not to safety.

Very low-certainty evidence means that we are not sure whether BPO will lead to more side effects in participants receiving medium- and long-term treatment than in those who did not receive treatment/received placebo (21 studies), received adapalene (seven studies), erythromycin (one study), or salicylic acid (one study).