Benzoyl Peroxide for Acne: How It Works, Best Products, Side Effects and More

• Benzoyl peroxide is one of the most popular and widely-used acne treatments
• It’s available in over the counter and prescription formulations, and can be used as an all-over or spot treatment
• Benzoyl peroxide is an antimicrobial that kills acne-causing bacteria
• It is found within cleansers, gels, moisturizers, toners and creams

If you experience breakouts, you have likely heard of benzoyl peroxide for acne. Benzoyl peroxide clears pores and fights acne-causing bacteria – two important mechanisms in the treatment of this skin condition. It’s one of the best acne treatments available and is found in multiple formulations. 

What Is Benzoyl Peroxide?

Benzoyl peroxide is one of the most common ingredients found in over-the-counter (OTC) medications for mild to moderate acne. Stronger concentrations are also available in prescription form.

Prescription brand names of medications that contain benzoyl peroxide include Epiduo, Benzamycin, Duac, Onexton, Acanya and BenzaClin. 

Benzoyl peroxide is available in gels, creams, moisturizers, cleansers and toners. It can be used as an all-over skin treatment or as a spot treatment on pimples and pustules. 

How Benzoyl Peroxide Works to Treat Acne

Benzoyl peroxide acne medication effectively cleanses and exfoliates blocked pores, reduces excess oil, treats inflammation and fights Propionibacterium acnes, the bacteria associated with acne. It treats active acne lesions and helps prevent future breakouts from forming. 

Due to its antimicrobial benefit benzoyl peroxide is most effective against nodules, cysts, pustules and papules, the lesions that typically accompany inflammatory acne. These appear as small or large red pus-filled bumps or pimples with white heads.

For some people, it is also an effective treatment for cystic acne. Cystic acne’s blemishes are unlike inflammatory acne and instead present as large, hard bumps. Because benzoyl peroxide kills P. acnes bacteria under the skin, it can effectively treat cystic acne’s deep blemishes.

It can also moderately reduce noninflammatory acne blemishes but is not the favored treatment. These blemishes don’t respond well to benzoyl peroxide and require different medications such as topical retinoids to effectively treat the whiteheads and blackheads associated with this type of acne.

Benzoyl peroxide for acne scars

Benzoyl peroxide is not an effective treatment for acne scars, but when used to treat acne, it can help prevent scars from forming in the first place. Using benzoyl peroxide to treat acne breakouts can help minimize or prevent papule and pustule formation to lower the risk of developing scar tissue. 

Best Benzoyl Peroxide Products for Acne

Benzoyl peroxide is available in a number of different skin care products to target adolescent and adult acne in different ways. These include: 

• Gels and creams have a higher benzoyl peroxide concentration and are designed as a spot treatment 
• Facial cleansers treat existing papules and pustules, and help prevent future breakouts
• Moisturizers and foams are applied to the entire face to treat and prevent acne 
• Body washes and soap address acne breakouts in areas other than the face, such as the back and chest

The best treatment will depend on your individual skin condition and preferences. To target the entire face, you may prefer a moisturizer or foam treatment. For those with dry skin and few lesions, you may opt for a two-step approach of gentle face wash and spot treatment. For the back or chest, soap or cleanser that rinses off would be ideal. 

Whatever your preference, it is important to be consistent with your acne treatment. Missing a day will set back your skin recovery; regular use of the same product will yield faster results.

How to Use Benzoyl Peroxide for Acne

Benzoyl peroxide is easy to incorporate into your daily skin care routine. For spot treatments, apply benzoyl peroxide after you cleanse your face and before you moisturize. If you normally use a facial cleanser, simply replace it with the medicated one and use as directed.

All benzoyl peroxide treatments may be used once or twice a day. If you’re using an OTC treatment, follow the directions on the label and discontinue use if you experience irritation. If you have a prescription, follow your doctor’s instructions for frequency of use. 

If you have sensitive skin or have never used benzoyl peroxide, it is recommended to start slowly and use it once a day beginning with a lower concentration. Once your skin becomes accustomed to the medication, you can slowly increase to the full dose. 

Best concentration 

Benzoyl peroxide for acne is available in a range of concentrations, from 2.5–10%. The severity of your condition and your skin type will determine the most appropriate concentration. 

Products such as spot treatments contain a higher concentration of benzoyl peroxide than cleansers and foams. While 10% benzoyl peroxide treatments may be appropriate for some people, the risk of side effects increases with higher concentrations.

Results 

Treatment results will vary depending on concentration and skin condition. If you’re using a spot treatment with a higher concentration of benzoyl peroxide, you can expect to see results overnight – or at least within the first day or two. 

For formulations containing a lower concentration, you will have to wait longer to see results. How quickly you see improvements will also depend on your severity of acne.

How long does it take to work? 

Benzoyl peroxide treatments can take eight to ten weeks before you see results. Use your product consistently and as directed for best results. Avoid overusing also as this can increase your risk of side effects.

In the first 3 weeks of treatment, it is normal to experience increased breakouts. This is your treatment speeding up and causing skin to purge itself of dead skin cells and debris. This will resolve with time. 

If you haven’t seen results from an OTC benzoyl peroxide formulation within 12 weeks, talk to your doctor. They may prescribe a stronger concentration or change your medication.

Acne before and after benzoyl peroxide

Interactions and Side Effects

Benzoyl peroxide is generally considered safe for most skin types. However, some people experience side effects from using this medication. Most of the time these are mild and temporary, and occur when you first begin using the product.

Side effects of benzoyl peroxide include:

• Dryness
• Hives
• Irritation
• Peeling
• Redness
• Swelling
• Trouble
• breathing

If you think you may be having an allergic reaction to benzoyl peroxide, seek emergency medical help immediately. 

Benzoyl peroxide is known for staining hair and fabric, such as clothes, towels and pillowcases. Always wash your hands after applying any products to your skin. Additionally, avoid using this medication before you exercise to prevent your perspiration from transferring the medication to your hair or clothes. 

Don’t use benzoyl peroxide on sunburned skin or for conditions such as seborrheic dermatitis or eczema. 

Some topical acne medications should not be used simultaneously with benzoyl peroxide as they can result in negative interactions: 

• Adapalene
• Bexarotene
• Dapsone
• Isotretinoin
• Tretinoin 
• Trifarotene

Alternatives

If benzoyl peroxide isn’t right for you, there are other acne medications that can help you address your breakouts, which include:

• Antibiotics such as doxycycline, minocycline or tetracycline, which are more aggressive than benzoyl peroxide and because of this, are used only for the short term
• Retinoids, available in cream or gel, which help to clear and prevent clogged pores
• Salicylic acid works to penetrate and clear pores and reduce oiliness, all effective actions against whiteheads and blackheads
• Tea tree oil is an antimicrobial and anti-inflammatory treatment that can help reduce swelling and prevent lesions; it is proven to be as effective as benzoyl peroxide

Benzoyl peroxide is often combined with antibiotics such as tetracycline and doxycycline to increase its effectiveness for severe cases of acne. However, antibiotics are associated with more severe side effects. 

Benzoyl peroxide vs. salicylic acid

Similar to benzoyl peroxide, salicylic acid helps clear pores. It regulates skin cell turnover and acts as a natural exfoliant. However, benzoyl peroxide works best for inflammatory acne as it is an antimicrobial and kills the acne-causing bacteria associated with this form of acne. 

Salicylic acid does not have this quality and is therefore a more appropriate treatment for blackheads, whiteheads and small pimples – all symptoms of noninflammatory acne. This is due to its ability to penetrate deep into clogged pores to break up plugs and prevent them from returning.

Takeaway

Benzoyl peroxide is a mainstay treatment for acne and is available in both OTC and prescription formulations. It’s best used for inflammatory acne, as it’s an antimicrobial and kills the bacteria associated with inflammation. This medication also clears pores and reduces excess oil. 

Benzoyl peroxide is available in cleansers, gels, moisturizers, toners and creams and can be used as an all-over skin or spot treatment. Concentrations range from 2.5–10%. Your doctor will recommend a dosage and frequency based on your skin type and the severity of your acne. 

Generally speaking, OTC benzoyl peroxide products contain a lower concentration, while prescriptions contain more. 

If you have severe acne, your doctor may recommend switching medications or combining benzoyl peroxide with an oral antibiotic such as tetracycline. For noninflammatory acne, salicylic acid would be the optimal choice as it targets the lesions associated with this type of acne.