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Pros and Cons of Benzoyl Peroxide – Acne Treatment

With acne affecting more than 85% of the world’s teenagers, it’s not surprising that there’s a huge demand for treatments that are effective, conveniently available, and inexpensive as well. Now, pick any over-the-counter acne treatment product from your chemist and go through its ingredient list. Chances are that it contains benzoyl peroxide. Available in over-the-counter gels, cleansers and spot treatments, this ingredient comes in different concentrations for mild to moderate breakouts.

While benzoyl peroxide can effectively get rid of bacteria and dead skin cells that clog your pores, it has limitations. In this article, we’ll explore the pros and cons and when to speak to a doctor regarding your condition.

What is Benzoyl Peroxide?

Benzoyl peroxide (BPO) has been an important component of topical therapy for acne vulagaris for more than five decades due to its ability to markedly reduce Cutibacterium acnes (formerly Propionibacterium acnes) and inflammatory acne lesions and its ability to moderately reduce noninflammatory acne lesions [1]. Unlike antibiotics, which induce alterations in bacterial structure, specific enzymes, and/or nuclear cytoplasmic proteins, BPO is directly toxic to P.acnes and other bacteria [2].

When used to treat acne, benzoyl peroxide works by reducing the amount of acne-causing bacteria and by causing the skin to dry and peel. This ingredient also reduces oil production and can prevent folliculitis (or inflamed hair follicles).

Despite being a popular ingredient in a large variety of acne gels, cleansers, and other acne OTC products, has some shortcomings too.  But before we jump into that, let’s find out now this seemingly powerful ingredient treats acne.


How does Benzoyl Peroxide treat acne?

Benzoyl peroxide has bactericidal properties and helps treat acne by acting as an oxidizing agent on the skin’s surface. After it is absorbed by the skin, benzoyl peroxide transforms into benzoic acid, 95% of which is absorbed by the body for further excretion through the kidneys.

Cysteine in the skin metabolises the benzoic acid which then oxidises the bacterial proteins. Thus benzoic acid helps reduce acne vulgaris by minimizing the lipids, free fatty acids, and C.acnes [3].  

Essentially, when applied to the affected skin surface, benzoyl peroxide acts as an exfoliating agent and destroys bacteria too. Benzoyl peroxide also has anti-inflammatory properties that is able to effectively provide relief for active acne, while its anti-comedogenic properties help to keep pores clean and prevent clogging.

What are the side effects of benzoyl peroxide?

While considered safe for most people, benzoyl peroxide can cause side effects. This is especially the case when you first start using the product. It may be helpful to use it once a day, and then build up the frequency in application over time if your skin can tolerate it.

Dry skin

Bleaching effect on clothing and hair

Allergic reactions

Despite benzoyl peroxide being effective in exfoliating and removing dead skin cells, excess sebum and acne-causing bacteria, it also peels away the skin in the process. Benzoyl peroxide, given its potency, can cause mild dryness, erythema, and scaling of the skin [4].

As a result, the treated skin areas experience redness, peeling, itching, and irritation. These effects may be more significant for people with sensitive skin. It can leave the skin inflamed, red, dry, and even cracked if the benzoyl peroxide percentage is too high for your skin.

Benzoyl peroxide is a strong bleaching agent which can result in the discoloration of clothes and hair that come in contact with the topical product [5]. There have been some cases where benzoyl peroxide users have reported that the ingredient even stripped some colour off their hair.

Others who use benzoyl peroxide as an overnight treatment has reported their bedsheets being stained from the ingredient.

It is important to your hands thoroughly to keep your hands clean after applying the product on the acne-affected skin surfaces.

Similarly, it’s better to avoid using benzoyl peroxide before your regular workouts as it could seep into your clothing and hair along with sweat.

While allergic reactions from benzoyl peroxide are considered rare, they are still possible. Appearance of redness or irritation of the skin are reported in some cases.

In such situations, it's advisable to immediately discontinue using the benzoyl peroxide product or products. Seeking emergency medical support is advised in cases of more severe side effects such as swelling and breathing difficulty.

Benzoyl peroxide and skin conditions

Your skin type is a crucial factor in deciding if benzoyl peroxide or salicylic acid is an appropriate treatment for treating acne. These products are usually not recommended for people with sensitive skin as it is more susceptible to rashes, irritation, and other side effects. Similarly, benzoyl peroxide products are generally avoided for patients suffering from seborrheic eczema or eczema.

Benzoyl peroxide vs. Salicylic acid for acne

So which is better? Benzoyl peroxide or Salicylic acid for acne? While benzoyl peroxide is a staple for treating inflammatory acne, it’s worth considering salicylic acid if you also have noninflammatory acne (blackheads and whiteheads).

Both help clean pores, but salicylic acid’s primary role is to get rid of dead skin cells. Such exfoliating effects may help treat noninflammatory lesions. It also does not stain your hair or fabric like benzoyl peroxide can. But it can still lead to dry, red, and peeling skin, especially when you first start using a product containing salicylic acid.


Other alternatives to benzoyl peroxide

Benzoyl peroxide isn’t your only treatment for acne and acne scars. There are other ingredients that can also help treat bacteria, excessive oil, and dead skin cells too. Consider the following treatments:

  • Adapalene
  • Salicylic Acid
  • Tea Tree Oil


Adapalene is a topical retinoid or vitamin A derivative that is commonly used in acne treatment products. It works to fight acne by decreasing the formation of microcomedones, the tiny “seeds” that form under the skin surface when a hair follicle is blocked by sebum (waxy skin oil) and dead skin cells. It does this by increasing the rate of skin cell turnover, helping to unblock pores and the glands that produce sebum. Adapalene also helps to exfoliate pimples that have already formed and, as anti-inflammatory, decreases the inflammation of the pimple.

Adapalene is used for achieving skin benefits such as

  • Reduction of fine lines and dark spots
  • Enhanced skin texture
  • Reduced frequency of acne breakouts
  • Decrease the severity of acne outbreaks
  • Removal of existing acne

Salicylic Acid

Salicylic acid is a beta hydroxy acid (BHA). It’s well-known for reducing acne by exfoliating the skin and keeping the pores clear. Salicylic acid works to treat acne by unclogging the blocked pores. It does this by breaking down the bonds between dead skin cells so that they can release from the pore more easily, and breaking down oils, such as sebum.

Tea Tree Oil

Tea tree oil (TTO) is an essential oil that is steam-distilled from Melaleuca alternifolia tree, which is a plant native to Australia. It has been widely accepted that tea tree oil has antimicrobial and anti-inflammatory properties. This can help prevent acne lesions, while also reducing swelling associated with inflammatory acne.

In fact, one 2007 study found 5% tea tree oil gel to be effective in treating mild to moderate cases of acne [6]. The oil has traditionally been used to treat wounds and other skin ailments. Tea tree oil has strong antioxidant properties along with broad-spectrum anti-bacterial, anti-viral, anti-fungal, and anti-protozoal properties.

A clinical trial conducted on 124 patients showed that both, 5% tea-tree oil and 5% benzoyl peroxide significantly reduced the number of open and closed comedones. However, the patients treated with tea tree oil were reported to have experienced fewer side effects [7].


Benzoyl peroxide treatment for acne – key takeaways

For people seeking a solution to their acne-related problems, benzoyl peroxide products are an effective and affordable treatment option. However, caution is advised as it also brings the risk of side effects such as dry skin, irritation, redness, and swelling.

However, it is always advisable to consult a doctor on the potential side effects as well as the precautions to be taken while using benzoyl peroxide products. Schedule an appointment with us to find out the most suitable treatment option for your acne condition.