Benzoyl Peroxide

Benzoyl peroxide is available over the counter and as a generic medication and has been included on the List of Essential Medicines curated by the World Health Organisation. It is a bactericide, reducing the severity and number of lesions caused by acne, by killing off the propionibacterium acnes bacteria that causes the condition. Being bactericidal, rather than an antibiotic, in nature means that it does not allow the bacteria to build up a resistance to antibiotics.

Overview

Benzoyl peroxide is a generic, over-the-counter topical treatment, often used to treat mild to moderate cases of acne. It works by killing the propionibacterium acnes bacteria responsible for causing acne on the skin. Though usually employed exclusively for the treatment of acne, benzoyl peroxide can also prove useful in the treatment of other skin conditions, though this should be determined by your doctor, or other healthcare professional.

As well as its antibacterial properties, benzoyl peroxide also has a mild drying effect. This allows excess dirt and oils to be washed away from the skin, reducing the risk of further infection.

Benzoyl peroxide is available without a prescription, and there are many branded over-the-counter products that include it in their make-up. Benzoyl peroxide is a versatile chemical and is available in a number of dosage forms, including the following:

  • bar
  • soap
  • lotion
  • solution
  • cream
  • gel or jelly
  • liquid
  • pad
  • foam

Conditions Treated

  • acne – mild to moderate
  • other skin conditions, as direct by a medical professional

Type of Medicine

  • antibacterial

Side Effects

Along with its desired effect of reducing the number and severity of acne lesions, benzoyl peroxide can cause some unwanted effects. Whilst it is not expected that all of these side effects will occur, should any of them do so, they may require medical attention.

Should you exhibit any of the following side effects, you should immediately check with your doctor:

  • painful irritation of skin, including swelling, burning, severe redness, blistering, itching and crusting
  • skin rash
  • difficulty with breathing
  • fainting
  • hives
  • itching
  • swelling of the tongue, lips, face, or eyes
  • tightness in the throat

Should any of the following symptoms of an overdose of benzoyl peroxide occur, you should seek emergency help immediately:

  • severe swelling
  • itching
  • burning
  • redness
  • scaling of the skin

As well as more immediate side effects, some effects may occur that do not normally require medical attention. Such side effects often disappear during the course of treatment, as your body starts to adjust to the medication. Your doctor or other healthcare professional might give able to give you some advice on how best to reduce or prevent some of these less serious side effects. Check with your doctor should any of these effects last beyond a couple of days, or if they become bothersome.

  • peeling or dryness of the skin (this may take a few days of use before occurring)
  • redness of the skin, combined with a mild stinging, and a feeling of warmth

These lists are not exhaustive, and it is not unknown for side effects that have not been listed here to also occur in some patients. Should you exhibit any other side effects during your course of treatment, you should check with your doctor, pharmacist, or other healthcare professional.

Dosage

The recommended dosage of this benzoyl peroxide will vary from patient to patient. If prescribed, you should always follow your doctor’s instructions in its use. If using an over-the-counter brand of the chemical, be sure to follow the directions on the label. The information that follows includes the average doses of benzoyl peroxide only.

If either the label or your healthcare professional recommends a different dosage to those listed here, do not alter it, unless advised to do so by your doctor.

The amount of benzoyl peroxide that you use will depend upon the strength of the particular brand that you administer. Also, the number of applications you make each day, the time recommended between applications, and the amount of time you are expected to continue with the treatment all depend on the nature and severity of the medical condition for which you are using benzoyl peroxide.

For acne:

  • For topical application (cleansing bar):
  • Adults and children aged twelve or older: use the bar two or three times a day, or as directed by your doctor
  • Children under the age of twelve: the use and dosage should be ascertained by your doctor or healthcare professional

For topical application (cleansing cream, gel, or lotion):

  • Adults and children aged twelve or older: apply to the affected skin area(s) once or twice a day
  • Children under the age of twelve: the use and dosage should be ascertained by your doctor or healthcare professional

For topical application (facial mask):

  • Adults and children aged twelve or older: use one time a week, or as directed by your doctor
  • Children under the age of twelve: the use and dosage should be ascertained by your doctor or healthcare professional

For topical application (lotion):

  • Adults and children aged twelve or older: apply to the affected skin area(s) between one and four times each day
  • Children under the age of twelve: the use and dosage should be ascertained by your doctor or healthcare professional

For topical application (stick):

  • Adults and children aged twelve or older: apply to the affected skin area(s) between one and three times each day
    Children under the age of twelve: the use and dosage should be ascertained by your doctor or healthcare professional

If you miss a dose of benzoyl peroxide during your course of treatment, administer it as soon as possible. That said, should it nearly be time for your next dosage, skip the missed application, and return to your regular dosing schedule.

Use benzoyl peroxide only as directed by the instructions on the label, or as recommended by your prescribing doctor, or other healthcare professional. Do not use more of it than the label advises, unless your doctor recommends otherwise. Doing so might well result in severe irritation of the skin. Benzoyl peroxide is only to be used on the skin. Do not use benzoyl peroxide in or around the lips or eyes, or inside the nose, and avoid using it on sensitive areas of the neck.

When applying the medication, be sure to spread it away from these areas. Should you accidentally get some benzoyl peroxide on these areas, be sure to wash off with water immediately. Benzoyl peroxide normally comes with directions for use by the patient. Be sure to read these directions carefully before using. If you have any questions regarding the directions, consult your doctor or other healthcare professional.

Before you use an over-the-counter acne product containing benzoyl peroxide for the first time, be sure to apply a little amount to a small area of affected skin for three days, to ensure you do not have a reaction to the product. If no discomfort occurs, feel free to follow the directions for use on the product’s label.

Do not apply benzoyl peroxide to sunburned or windburned or onto open wounds, unless specifically advised to by your doctor.

To use the gel, lotion, cream, or stick:

  • Before application, wash the affected area of skin with nonmedicated soap and water, or with a mild nonmedicated cleanser, before gently patting dry with a towel
  • Apply sufficient medicine to cover the area of affected skin, and gently rub in

To use the shave cream:

  • Wet the area you intend to shave
  • Apply a little of the shave cream, rubbing gently over the entire area
  • Shave
  • Rinse the area of application and pat dry
  • Do not use aftershave lotion, or any other products that dry the face without first consulting your doctor

To use the cleansing lotion, cleansing bar, or soap:

  • Follow the instructions on the label, and ash the affected areas as directed.

To use the facial mask:

  • Before application, wash the area of affected skin with a nonmedicated cleanser, before rinsing and patting dry
  • Apply a thin layer of the mask, using a gentle circular rubbing motion, evenly over the area of affected skin
  • Allow the mask to dry, as directed
  • Rinse the area thoroughly with warm water, before patting dry

After applying benzoyl peroxide, wash your hands to remove any trace of medicine that might remain on them.

  • Avoid washing the treated areas of skin for an hour following application

Major Drug Interactions

There are certain medications that should never be used together. However, there are times when two different drugs might be used concurrently, even if there is a known risk of an interaction occurring. In such cases, your prescribing doctor might choose to change the dose or decide that other precautions are necessary.

There are certain types of medication that should not be used around the same time as eating food (or certain types of food) as unwanted interactions might occur. Using tobacco or alcohol at the same time as certain medications might also result in interactions. If you are concerned with possible interactions occurring during your course of treatment with benzoyl peroxide, be sure to discuss with your doctor.

Warnings

When choosing to use a medication, you should always weigh the potential risks of its use against the improvement it will make to your condition. This decision should be reached between you and a healthcare professional, taking into consideration all of the following points:

Inform your doctor if you have ever had an allergic or otherwise unusual reaction to benzoyl peroxide, or any other medication. You should also inform them if you suffer from any other types of allergy, including allergies to preservatives, foods, animals, or dyes.

You may experience irritation of the skin during the first three weeks of your course of treatment with benzoyl peroxide, and your acne maybe appear to worsen before it starts to get better. This is not unexpected. However, if your condition has not improved after four to six weeks of treatment, you need to consult your doctor.

There are certain over-the-counter acne products that might cause rare and life-threatening allergic reactions. If, during your course of treatment, you develop hives, trouble breathing, itching, tightness in the throat, swelling of the tongue, lips, eyes, or face, or feeling faint, you should immediately consult your doctor.

If you exhibit a serious allergic reaction to an over-the-counter acne product containing benzoyl peroxide, refrain from using it again. Do not apply any other sort of topical medication to the same area of affected skin within one hour of using benzoyl peroxide, or the drug may not work as expected.

Unless advised otherwise by your doctor or another healthcare professional, it is particularly important that you avoid applying the following skin products to the same areas as benzoyl peroxide:

  • Any skin product or other topical acne product that contains peeling agents such as resorcinol, sulfur, salicylic acid, or tretinoin
  • Any hair products that cause irritation, including hair removal products and permanent dyes.
  • Skin products containing spices or lime, or that otherwise cause sensitivity to the sun
  • Skin products which contain large amounts of alcohol, including aftershave lotions, astringents, and shaving creams
  • Skin products that dry out the skin, or are too abrasive, including certain soaps, skin cleansers, and cosmetics

Using these types of products alongside benzoyl peroxide might cause some mild to severe irritation to your skin. Whilst skin irritation may occur, some doctors will allow you to use benzoyl peroxide alongside tretinoin as a treatment for acne. Tretinoin is normally applied at night, so it shouldn’t cause any problem used in conjunction with another topical product, such as benzoyl peroxide that you may be using throughout the day. Benzoyl peroxide might bleach hair or colored fabrics.

If your skin becomes too irritated or dry, check with your doctor, who should be able to assist you in choosing the correct skin products to help in the reduction of skin dryness. Having other medical conditions aside from your acne might affect your use of benzoyl peroxide. Be sure to speak with your doctor should you suffer from any other conditions, particularly:

  • seborrheic dermatitis
  • eczema
  • raw or reddened skin, including sunburnt

Storage

Benzoyl peroxide should be kept in a closed container, away from heat, direct light, and moisture. It should be stored at room temperature and kept from freezing.
Benzoyl peroxide should always be kept beyond the reach of children. It is important that you do not keep hold of medication that you no longer require, or that is outdated. If you are unsure of how to dispose of any benzoyl peroxide that you do not use, be sure to ask your doctor.

Summary

Benzoyl peroxide is a generic topical medication regularly used in the treatment of mild to moderate acne. Though it can sometimes cause a severe skin rash for people with sensitive skin, it remains one of the most popular remedies for this condition. Several branded acne-relief products incorporate benzoyl peroxide, which is one of the medications included on the List of Essential Medicines compiled by the World Health Organisation.

Resources
Last Reviewed:
December 25, 2017
Last Updated:
December 22, 2017