Benzoyl Peroxide for Acne: Side Effects & Benefits

Acne is one of the most common skin conditions, and it affects some 50 million Americans. Approximately 85% of adolescents and young adults have at least minor acne, but it can persist well into adulthood. Benzoyl peroxide topical is one of the medications used to treat acne. Though acne is not life-threatening, this medical problem can significantly affect a person's self-esteem and quality of life. Please continue reading to learn more about the benefits of using benzoyl peroxide as well as the side effects.

What is topical benzoyl peroxide?

Topical benzoyl peroxide is an over-the-counter (OTC) treatment for acne. Benzoyl peroxide is available in different concentrations for treatment of different severity levels of acne. In addition to OTC products, there are prescription medications containing this medication.

Benzoyl peroxide is an ingredient in many anti-acne topical products such as gels, lotions, creams, cleansers, and soap bars. These products are sold under brand names such as Benzac AC, Clearasil Stubborn Acne Spot Treatment, NeoBenz Micro, Persa-Gel 10, and many others.

Benzoyl peroxide topical is sometimes combined with other ingredients used for acne treatment, for example, salicylic acid, sulfur, topical retinoids like adapalene, antibiotics like clindamycin or erythromycin, and corticosteroids like hydrocortisone.

How does benzoyl peroxide treat acne?

Benzoyl peroxide is a bactericidal agent and is effective against Cutibacterium acnes (C. acnes). In other words, benzoyl peroxide works by killing bacteria in the skin that cause acne vulgaris, the most common form of acne.

What are the benefits of benzoyl peroxide for acne?

The benefits of using benzoyl peroxide topical medicine for treating acne include:

Bactericidal effect (kills bacteria that cause acne).
Mild sebostatic properties (slows the production of sebum, an oily substance in the skin that can contribute to acne).
Mild keratolytic effects (breaks down the outer layers of skin, removes dead skin cells, and increases skin moisture).
Unlike antibiotic resistance, continued use of benzoyl peroxide does not lead to drug resistance.
Works effectively in combination with other acne therapies.

What are the side effects of benzoyl peroxide topical?

Common side effects of benzoyl peroxide topical include dryness, warmth, and mild skin irritation such as peeling, stinging, and burning. If you have sensitive skin and over-the-counter acne products cause skin irritation, stop using the product and talk to a healthcare professional (dermatologist).

More serious side effects of benzoyl peroxide topical include allergic reactions. Seek immediate medical help for the following side effects: rash, hives, redness, swelling, burning, and blisters in the treated area (similar to contact dermatitis). Other signs of a severe allergic reaction include difficulty breathing, throat tightness, swelling of the face or mouth, and fainting.

Stop topical treatment with benzoyl peroxide products and seek immediate medical attention if you develop severe irritation or a serious allergic reaction after using acne treatments. You can also call the national poison control center at 1-800-222-1222.

How to use benzoyl peroxide for acne treatment?

Apply benzoyl peroxide to a small area of skin once daily for 3 days to test the product when you first begin using it. If there is no discomfort or reaction, use the product as directed on the package or prescription label.

Clean your skin with a mild cleanser and warm water and gently pat dry. Apply a thin layer of benzoyl peroxide on the entire area affected by acne 1-3 times a day, and gently rub it in.

Start with a lower concentration once-daily application of the topical cream, lotion, or gel and then slowly increase to higher concentrations and 2-3 times daily applications as suggested on the patient information leaflet or as prescribed by your healthcare professional. Use the benzoyl peroxide bar to wash the affected area.

Reduce the application back to once daily or a lower concentration if benzoyl peroxide causes adverse effects such as excessive dryness, peeling, or other effects.

What precautions to take while using benzoyl peroxide?

Wear sunscreen when going outdoors. Apply sunscreen on top of benzoyl peroxide acne products in the affected areas.

If you develop irritation or an allergic reaction, stop using benzoyl peroxide and other skin products such as moisturizers or shaving creams, and consult a doctor.

Using benzoyl peroxide with other drugs for acne vulgaris can lead to excessive dryness or irritation due to drug interactions. Your doctor may recommend trying an essential oil such as tea tree oil which can help control acne with fewer side effects.

Avoid contact with benzoyl peroxide products with your eyes, lips, and mouth. Also, avoid skin irritants during benzoyl peroxide treatment, such as harsh soaps or cleansers, skin products that contain alcohol, cosmetics that contain a drying or peeling agent, other topical medications unless prescribed by a healthcare provider, sunlamps, and excessive sunlight exposure.

If you miss an application of topical benzoyl peroxide, use it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. Do not use extra medicine to make up for a missed dose.

You should talk to a doctor before using benzoyl peroxide products in the pediatric population (children under 12 years of age). Talk to your healthcare provider before using benzoyl peroxide topical if you are pregnant or breast feeding.

Avoid contact with colored fabrics. Benzoyl peroxide may result in stained clothing as it has a bleaching effect.

How quickly does benzoyl peroxide treat acne?

It can take 4-6 weeks to get the full benefits of topical benzoyl peroxide. Talk to your doctor if your acne does not improve after using over-the-counter benzoyl peroxide products for 6 weeks.

What is the best acne treatment?

The first line of treatment for mild acne is usually topical benzoyl peroxide or a combination of benzoyl peroxide with topical retinoids with or without a topical antibiotic. The new treatment paradigm is to focus on four targets. They are inflammation, hyperkeratinization (thickening of the skin in response to pressure, irritation, or inflammation), excess sebum (the oily, sticky substance secreted by the sebaceous gland), and Cutibacterium acnes.

For moderate acne, healthcare providers may add an oral antibiotic to the regimen. Severe acne may require the addition of oral isotretinoin to the above acne treatments. In addition, oral contraceptive pills or oral spironolactone may be used in those who are assigned female at birth.

The type of acne vulgaris can also help in deciding the best treatment. Comedonal acne with pimples, blackheads, and whiteheads usually responds well to topical keratolytics such as benzoyl peroxide, salicylic acid, adapalene, and tretinoin. Inflammatory acne is treated with topical therapies and oral antibiotics. Nodulocystic acne usually requires a 2- to 3-month course of oral antibiotics or isotretinoin, followed by topical therapy for long-term management.

Typically, oral antibiotics are prescribed for 12 weeks to reduce the risk of bacterial resistance. Therefore, it is very important that you take the antibiotic exactly as prescribed. Bacterial resistance is when a bacteria or fungi evolve and develop a defense mechanism against the antimicrobial drugs designed to kill them. Topical retinoids should be continued until the acne is clear.

How to get rid of acne scars?

Acne can leave behind permanent scars after it heals. There are various treatment options available for acne scars, ranging from skincare with medicated creams containing azelaic acid to cosmetic treatments such as soft tissue fillers, chemical peels, laser resurfacing, pulsed light therapy, micro-needling, and dermabrasion. Doctors may offer steroid injections for raised scars, punch excision (surgical removal) of certain acne scars, or botulinum toxin type A injections (Botox) to help improve the puckering area around acne scars.

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