For over half a century, benzoyl peroxide (BPO) has been considered a titan in the arena of anti-acne treatments. From cleansers to body washes, spot treatments to lotions, the number of products incorporating this stellar ingredient continues to grow.

Let’s take a closer look at why BPO remains a force to reckon with in the fight against acne.

What is benzoyl peroxide?

Benzoyl peroxide is a chemical compound that has antiseptic, keratolytic, comedolytic and anti-inflammatory properties.

BPO can be used alone in varying concentrations, or in combination with other active ingredients such as antimicrobials or retinoids for a synergistic action.

 

How does BPO work?

Benzoyl peroxide works primarily by inhibiting the growth of acne-causing bacteria. Remember that Cutibacterium acnes, the bacteria most associated with zits, is anaerobic (ie it survives in the absence of oxygen). That’s maybe why a clogged pore is a great place for it to multiply. In a nutshell, benzoyl peroxide creates oxidises proteins of the bacteria inside the pore, which releases reactive oxygen species which is toxic to the bacteria.

When BPO is administered on the skin, it breaks through the epidermis and works its magic deeper within the pores. In the process of metabolizing the BPO, oxygen is produced and kills the bacteria. It’s pretty good at it too, even when compared to antibacterials such as erythromycin and clindamycin. And unlike these compounds, use of BPO does not lead to resistant strains of P. acnes. Studies report over 95% reduction in the amount of bacteria after one week of twice-a-day BPO use. This translated into a noticeable reduction in the number of spots within a few weeks to a few months of use.

In addition to killing the inflammation-triggering bacteria, BPO also has keratolytic effects. It helps break down the keratin that plugs up our pores, which is the reason why anaerobic bacteria thrive there in the first place. 

What are the side effects of BPO?

Benzoyl peroxide’s keratolytic effect has a tendency to cause drying for the first few weeks of use. There are several ways to work around this. One good option is to try using a lower strength product. Studies show that 2.5% BPO has the same efficacy but less reported side effects than 5% or 10%. You can also build up usage over time--say use it thrice a week for the first week, then slowly increase frequency until your skin is able to tolerate daily use. And the best way to help improve dryness is to use a mild, non-comedogenic moisturizer once BPO has dried and been fully absorbed into the skin.  But better still, when combined with the right moisturising ingredients as a single product as is done by SkinKitz, you mitigate those unwanted side effects with the application of a single cream.

Because BPO can cause drying and peeling, it can make your skin more sensitive to the sun. Make sure to use a broad-spectrum sunscreen or moisturiser with at least SPF 30+ to help protect from harmful rays.

The reactive oxygen species produced by BPO is proven to kill off bacteria, but at the same time, there are some scientific studies suggesting it can depletes the skin’s store of Vitamin E. You can consider restoring the supply of this important antioxidant by using topical products with Vitamin E, or better still, have it added to your benzoyl peroxide cream by the SkinKitz team!

BPO is also known to bleach clothes. You have to make sure that your skin is completely dry before putting on clothes or lying on sofas and beds. 

Note that there is a small percentage of the population who are allergic or reactive to BPO. While a minor red reaction can be normal when you first start using the product, you should discontinue use if there is swelling, persistent crustiness, and excessive redness. 

 

How can I incorporate BPO into my routine?

Benzoyl peroxide can be used as a leave-on or a wash-off product. Leave-on products such as creams, gels, spot treatments, and lotions are usually found at lower concentrations (2.5% to 5%), as the length of time it stays on the skin strengthens the effect. 

Wash-off products like cleansers or body washes often have higher concentrations to allow for action of the ingredient.  

There are 2-in-1 products that include benzoyl peroxide and other anti-acne treatments with a different mechanism of action. You can find products that combine BPO and an antibiotic, or BPO and a retinoid. Because its active ingredients target different factors in the pathogenesis of acne, these products are typically more effective.

If you have an existing anti-acne routine and want to incorporate BPO into it, make sure to do your research first. BPO can cause irritation, so using it in conjunction with other irritating products can do more harm than good in some. Many people space out their actives, using one strong chemical in the morning, and a different one at night. It’s best to use BPO with mild, non-comedogenic products to avoid further irritation. And don’t forget to protect your skin with sunscreen!

Because BPO does not cause antimicrobial resistance, it can be used for long-term acne therapy and post-breakout maintenance.

Conclusion

With its antiseptic and keratolytic properties, inability to cause resistance, and good safety profile, there’s no wonder that dermatologists always reach for BPO for their acne-prone patients. As in any acne medication, you should be in it for the long haul. Even the best acne treatments will take time to work. With consistent and proper use, benzoyl peroxide stands a high chance of being a staple in your efforts to banish your acne.

This content is for general information only and is not a substitute for medical advice.

Resources: 

Del Rosso J. Q. (2008). Benzoyl peroxide cleansers for the treatment of acne vulgaris: status report on available data. Cutis, 82(5), 336–342.

Matin T, Goodman MB. Benzoyl Peroxide. [Updated 2020 Mar 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537220/

Mills, O. H., Jr, Kligman, A. M., Pochi, P., & Comite, H. (1986). Comparing 2.5%, 5%, and 10% benzoyl peroxide on inflammatory acne vulgaris. International journal of dermatology, 25(10), 664–667. https://doi.org/10.1111/j.1365-4362.1986.tb04534.x

Oon, H. H., Wong, S. N., Aw, D., Cheong, W. K., Goh, C. L., & Tan, H. H. (2019). Acne Management Guidelines by the Dermatological Society of Singapore. The Journal of clinical and aesthetic dermatology, 12(7), 34–50.

Valacchi, G., Rimbach, G., Saliou, C., Weber, S. U., & Packer, L. (2001). Effect of benzoyl peroxide on antioxidant status, NF-kappaB activity and interleukin-1alpha gene expression in human keratinocytes. Toxicology, 165(2-3), 225–234. https://doi.org/10.1016/s0300-483x(01)00430-9

https://www.acne.org/how-does-benzoyl-peroxide-work-in-the-skin.html

The information presented in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  SkinKitz does not provide any mental health advice or treatment.  If you are experiencing any mental health concerns, please see your GP or mental health professional.