Benzoyl Peroxide 101: A Detailed Guide

Acne is the most common skin condition in the world, so it's no wonder benzoyl peroxide is almost like a rite of passage for people.

What Is Benzoyl Peroxide?

Potential Benefits of Benzoyl Peroxide

Benzoyl peroxide is considered one of the go-to acne-fighting ingredients for a reason: It’s effective. “Benzoyl peroxide is predominantly used for the treatment and prevention of acne,” says Elizabeth Bahar Houshmand, MD, a double board-certified dermatologist in Dallas.

Here’s how benzoyl peroxide may benefit skin.

Treats Current Acne

“Benzoyl peroxide is effective for mild to moderate inflammatory acne because it reduces acne-causing bacteria and reduces inflammation,” says Marisa Garshick, MD, a board-certified dermatologist in New York City. On the other hand, “It’s not as effective for clogged pores (comedonal acne), which often requires a retinoid or salicylic acid, and benzoyl peroxide alone may not be sufficient to treat severe acne, which often requires prescription treatments, including oral medications to minimize the potential for scarring.”

Helps Prevent New Pimples From Forming

While benzoyl peroxide can’t address all these causes, the ingredient can make a difference. “Benzoyl peroxide is directly toxic to [acne-causing] bacteria,” says Dr. Houshmand. “It can work on the skin surface and within the hair follicles.”

May Prevent Scarring

Types of Skin-Care Products That Contain Benzoyl Peroxide

• Lotions
• Creams
• Gels
• Foams
• Solutions
• Cleansing bars
• Pads
• Face masks

“Patients worried about utilizing benzoyl peroxide and combination medications containing it should speak with a board-certified dermatologist and [possibly discuss] alternative options,” says Camila K. Janniger, MD, a clinical professor of dermatology at the Rutgers New Jersey Medical School in Newark.

Potential Side Effects of Benzoyl Peroxide

If you have very sensitive skin, eczema, or rosacea, be cautious when using benzoyl peroxide because it can cause irritation and dryness, says Dr. Garshick. “It’s best to consult with a dermatologist before using benzoyl peroxide products if you have any of these conditions,” she advises.

• Skin irritation
• Dryness
• Redness
• Flaking or peeling
• Increased skin sensitivity to light

Does Benzoyl Peroxide React With Other Ingredients?

Dermatologists often recommend using benzoyl peroxide with retinoids or topical antibiotics to optimize treatment, says Garshick. “Retinoids like tretinoin can help with cell turnover and reduce clogged pores, while antibiotics such as clindamycin can further reduce bacteria and inflammation,” she says.

But in some cases, when benzoyl peroxide is used with other active skin-care ingredients, such as retinoids or salicylic acid, they can interact and increase the risk of irritation and dryness, especially if you’re not using them under the guidance of your dermatologist, says Garshick.

Is Benzoyl Peroxide Safe to Use During Pregnancy?

Benzoyl Peroxide Alternatives

If benzoyl peroxide is not right for you because of skin irritation, other side effects, or for another reason, alternatives such as salicylic acid or sulfur-containing products can be used in place of benzoyl peroxide, says Garshick.

“For patients with sensitive skin, oral antibiotics remain an option,” says Janniger, who notes that dermatologists can help patients select the most effective remedy for them.

How to Add Benzoyl Peroxide to Your Skin-Care Routine

To reduce your chances of experiencing side effects such as dryness and skin irritation, start with a lower concentration of benzoyl peroxide — typically listed on the product label with a range between 2.5 and 10 percent — and add it to your skin-care routine slowly, says Garshick. Here are some other tips to keep in mind, according to Garshick.

• Build the rest of your skin-care routine mindfully. Consider using a gentle cleanser that won’t strip the skin of its natural oils and a noncomedogenic moisturizer to help soothe the skin and keep the skin hydrated. Also, avoid using benzoyl peroxide at the same time as other harsh active ingredients like retinoids or exfoliating acids.
• Limit sun exposure and use sunscreen. Benzoyl peroxide can make your skin more sensitive to the sun.
• Watch for signs your skin isn’t tolerating the ingredient well. If your skin becomes irritated, stop using benzoyl peroxide temporarily until your doctor gives you the go-ahead to resume.

Another way to decrease the risk of side effects is to start with a benzoyl peroxide cleanser, suggests Jenny Liu, MD, a board-certified dermatologist based in Minneapolis. “Cleansers can work just as well as leave-on products, but cause less irritation because they are washed off,” she says. Her pro tip: After massaging your cleanser into your skin, leave it on for a few minutes before rinsing.

When to Use Benzoyl Peroxide

Benzoyl peroxide can be used in the morning and applied at night, depending on what your doctor recommends, says Garshick. If you’ve been prescribed tretinoin, your doctor may advise alternating with benzoyl peroxide. “It’s often recommended to use tretinoin or retinol at night and benzoyl peroxide during the day, which can help lessen irritation,” says Garshick.

Start by washing your face with a gentle cleanser; then apply a benzoyl peroxide treatment to the affected areas, followed by a moisturizer, says Garshick.

How Often Should You Use Benzoyl Peroxide?

Benzoyl peroxide can be used daily, but if you’re first introducing it to your skin-care routine, apply it every other day to see how your skin reacts before gradually increasing usage while your skin builds tolerance, says Garshick.

Start with a low concentration once daily and to apply a noncomedogenic moisturizer, such as hyaluronic acid, to reduce the prospect of irritation, says Janniger.

The Takeaway

Benzoyl peroxide is an effective topical medication for the treatment and prevention of mild acne. Considering how well it works, it’s no wonder that many teens and adults have reached for products with this ingredient to banish breakouts. And while it can cause side effects such as dryness and irritation, you can reduce your risk by following your doctor’s recommendations, and by applying a moisturizer.