Benzoyl Peroxide (BPO) – The Good

Benzoyl Peroxide is a very effective treatment against acne, but it also can have undesirable side effects for some people.  Side effects can include excessive dryness, burning, tingling, itching, flaking and irritation.  Benzoyl Peroxide works by preventing P. Acne bacteria from reproducing, so it is only a temporary solution to treat acne.  New forms of micronized “microsphere” BPO allow for a slow release of BPO onto the skin which reduces the side effects.

In 2010, the Food and Drug Administration (FDA), issued a final rule to include benzoyl peroxide as a generally recognized as safe and effective (GRASE) active ingredient in over-the-counter (OTC) topical acne drug products.

BPO is generally available in commercial Over The Counter formulations at concentrations ranging from 2.5% to 10.0%.  Research has found that BPO in concentrations of 2.5%, 5% and 10% are equally effective at treating inflammatory acne. However, higher concentrations are associated with more adverse effects, but not with increased effectiveness. The efficacy of BPO may also be enhanced by the presence of Vitamin E.

When using BPO to treat acne, it is recommended that you use formulations no greater than 2.5% BPO.  This concentration level will provide you with the same effectiveness as higher concentrations, but with substantially reduced potential for side effects.

The Take Away:  BPO at 2.5% concentration is a safe, effective treatment for acne.  Look for BPO formulations that specifically contain “micronized” or “microsphere,” slow-release forms of BPO.  If you experience any of the side effects that can be associated with BPO, cease using it immediately.


Benzoyl Peroxide – The Bad 

As discussed above, some people experience undesirable, but not harmful, side effects from using BPO acne treatments.

Side effects can include excessive dryness, burning, tingling, itching, flaking and irritation.

Look for these statements on the Warning Label of BPO containing products:

Do not use if you:

● have very sensitive skin

● are sensitive to benzoyl peroxide

When using this product:

● avoid unnecessary sun exposure and use a sunscreen

● avoid contact with the eyes, lips, and mouth

● avoid contact with hair and dyed fabrics, which may be bleached by this product

● skin irritation may occur, characterized by redness, burning, itching, peeling, or possibly swelling. Irritation may be reduced by using the product less frequently or in a lower concentration.

● if going outside, apply sunscreen after using this product. If irritation or sensitivity develops, stop use of both products and ask a doctor.

Stop use and ask a doctor if:

● irritation becomes severe


Benzoyl Peroxide – The Ugly

In June 2014, The Food and Drug Administration issued a warning that some common over-the-counter acne treatments can cause severe irritation or even life-threatening allergic reactions.

The products — available as gels, lotions, face washes, solutions, cleansing pads, toners and face scrubs — contain benzoyl peroxide or salicylic acid.

The FDA says the potentially serious allergic reactions such products can cause — throat tightness, shortness of breath, wheezing, low blood pressure, fainting, or collapse — are not listed on their labels along with the less serious reactions that do appear there, such as dryness, itching, burning, peeling, redness and slight swelling.

Between 1969 and February 2013 the FDA received 131 reports of serious allergic reactions to these types of acne products in people ages 11 to 78. Though no deaths were reported, 44 percent of the patients required hospitalization, the FDA noted in a statement, adding that it will continue to monitor the situation.

While the cases of hypersensitivity reaction to the acne products are rare, the potential for the reactions to be life-threatening is what led to the FDA’s warning

The Take Away:  In over 40 years of use, there were only 131 reports of the millions of people who used BPO topical treatments for acne.  While it is extremely rare, these reactions are cause for concern.  Use BPO prudently and if you experience any side effects, discontinue use immediately.