Almost all over-the-counter acne products available today contain benzoyl peroxide. It is a very effective anti-acne agent that is safe and has few side effects. Benzoyl peroxide acne treatment is appropriate for mild to moderate cases of acne that include comedones, papules and pustules. This chemical is the active ingredient in many acne preparations such as:
- Clean & Clear (some products)
- Clearasil (some products)
- Oxy (some products)
- Proactiv (2.5% concentration in its cleanser and treatment lotion)
It is available in creams, lotions, gels, pads, foams, cleansers, and soaps and is sold in concentrations of 2.5%, 5%, and 10%. It is sometimes combined with erythromycin or clindamycin in topical creams for infected acne.
How it Works
Benzoyl peroxide works against acne in at least two ways. First, it is a peeling agent (exfoliant), increasing skin cell turnover and clearing the pores to prevent sebum buildup and pore blockage. Secondly and more importantly, it is a strong bactericidal agent, killing the p. acnes bacteria responsible for acne directly. As acne expert Dr. Julie C. Harper attests, "Benzoyl peroxide [BPO] is a broad-spectrum antibacterial agent ... with no resistance reported to date."
In general, 2.5% peroxide benzoyl is effective for most people. Patients with more oily skin or with better tolerance can use the higher concentrations. Ideally it should be used daily, although the frequency can be adjusted according to need.
Benzoyl peroxide vs. salicylic acid for acne
Benzoyl peroxide is frequently compared against salicylic acid, another common and effective over the counter acne treatment product. As discussed earlier, benzoyl peroxide kills bacteria and exfoliates the skin. Salicylic acid, on the other hand, has no effect on acne-causing bacteria; it improves acne by exfoliating action alone.
Which one to use depends on your skin's reaction. Benzoyl peroxide tends to be harsher on the skin for most people than salicylic acid. If your skin can take it, go for benzoyl peroxide. However, those with sensitive skin would probably benefit more from salicylic acid because it is gentler and less likely to cause irritations.
Guidelines and Precautions
Unless your doctor has told you otherwise, do not use benzoyl peroxide with other acne medications. Doing so may lessen the effectiveness of your treatment. In particular, it must not be used with tretinoin (Altinac, Avita, Renova, Retin A, Tretin X) at the same time; not only does it deactivate tretinoin, but this combination could also cause severe skin irritation.
Start your treatment with creams or gels at 2.5% concentration until your skin adjusts to the product. If you have sensitive skin, you may use it every 2 days in the beginning, then going daily later. It will dry your skin so be sure to use a noncomedogenic moisturizer. Apply your medication in the evening and wash your face in the morning.
Beware that benzoyl peroxide has a mild bleaching effect due to its peroxide component. Thoroughly wash your hands after application and keep it away from your clothes, towels, and bedding.
Do not use this medication on dry, chapped, windburned, sunburned, irritated, or broken skin. Consult your doctor immediately if you experience signs of allergy like burning, itching, and swelling.
How long to see results?
For best results, keep using the medication consistently and as directed. Initial improvements may be seen within 6 weeks but in most cases, you will need 8-12 weeks before it starts clearing your skin.