Benzoyl Peroxide

Topical Antibacterial

What Is It?

Benzoyl peroxide is a topical treatment that kills acne bacteria and dries/peels the skin, helping to keep pores unclogged.

Efficacy

Strength of Evidence
1
2
3
4
5
Average 54% reduction in acne after 8 weeks
  1. Kaewsanit, T., Chakkavittumrong, P. & Waranuch, N. Clinical comparison of topical 2.5% benzoyl peroxide plus 5% niacinamide to 2.5% benzoyl peroxide alone in the treatment of mild to moderate facial acne vulgaris. J Clin Aesthet Dermatol. 14, 35–41 (2021).
  2. Webster, G. F., Sugarman, J., Levy-Hacham, O. & Toledano, O. Microencapsulated benzoyl peroxide and tretinoin for the treatment of acne vulgaris: results from a phase 2 multicenter, double-blind, randomized, vehicle-controlled study. Skinmed 18, 343–351 (2020).
  3. Tantipunpipat, S., Weschawalit, S. & Chakkavittumrong, P. Comparação clínica entre peróxido de benzoília tópico 2,5% e diclofenaco gel 1% versus peróxido de benzoília 2,5% e placebo no tratamento da acne vulgar facial leve à moderada. S&CD 12, (2020).
  4. Patiyasikunt, M., Chancheewa, B., Asawanonda, P., Noppakun, N. & Kumtornrut, C. Efficacy and tolerability of low-dose spironolactone and topical benzoyl peroxide in adult female acne: A randomized, double-blind, placebo-controlled trial. J Dermatol 47, 1411–1416 (2020).
  5. Lubtikulthum, P., Kamanamool, N. & Udompataikul, M. A comparative study on the effectiveness of herbal extracts vs 2.5% benzoyl peroxide in the treatment of mild to moderate acne vulgaris. J Cosmet Dermatol 18, 1767–1775 (2019).
  6. Kawashima, M. et al. Twelve-week, multicenter, placebo-controlled, randomized, double-blind, parallel-group, comparative phase II/III study of benzoyl peroxide gel in patients with acne vulgaris: A secondary publication. J Dermatol 44, 774–782 (2017).
  7. Kawashima, M., Nagare, T. & Katsuramaki, T. Open-label, randomized, multicenter, phase III study to evaluate the safety and efficacy of benzoyl peroxide gel in long-term use in patients with acne vulgaris: A secondary publication. J Dermatol 44, 635–643 (2017).
  8. Richter, C. et al. Reduction of inflammatory and noninflammatory lesions with topical tyrothricin 0.1% in the treatment of mild to severe acne papulopustulosa: a randomized controlled clinical trial. Skin Pharmacol Physiol 29, 1–8 (2016).
  9. Nestor, M. S., Swenson, N., Macri, A., Manway, M. & Paparone, P. Efficacy and tolerability of a combined 445nm and 630nm over-the-counter light therapy mask with and without topical salicylic acid versus topical benzoyl peroxide for the treatment of mild-to-moderate acne vulgaris. J Clin Aesthet Dermatol 9, 25–35 (2016).
  10. Jawade, S. A., Saigaonkar, V. A. & Kondalkar, A. R. Efficacy and tolerability of adapalene 0.1%- benzoyl peroxide 2.5% combination gel in treatment of acne vulgaris in indian patients: a randomized investigator-blind controlled trial. Iranian Journal of Dermatology 19, 105–112 (2016).
  11. Tabasum, H., Ahmad, T., Anjum, F. & Rehman, H. The effect of Unani antiacne formulation (Zimade Muhasa) on acne vulgaris: A single-blind, randomized, controlled clinical trial. Journal of Pakistan Association of Dermatologists 24, 319–326 (2014).
  12. Kawashima, M., Hashimoto, H., Alio Sáenz, A. B., Ono, M. & Yamada, M. Is benzoyl peroxide 3% topical gel effective and safe in the treatment of acne vulgaris in Japanese patients? A multicenter, randomized, double-blind, vehicle-controlled, parallel-group study. J Dermatol 41, 795–801 (2014).
  13. El-Latif, A. A. A., Hassan, F. A. A., Elshahed, A. R., Mohamed, A. G. & Elsaie, M. L. Intense pulsed light versus benzoyl peroxide 5% gel in treatment of acne vulgaris. Lasers Med Sci 29, 1009–1015 (2014).
  14. Babaeinejad, S. H. & Fouladi, R. F. The efficacy, safety, and tolerability of adapalene versus benzoyl peroxide in the treatment of mild acne vulgaris: a randomized trial. Journal of Drugs in Dermatology 12, 790 (2013).
  15. NCT01188538. Anti propionibacterium(p.) Acnes activity of Epiduo® gel compared to benzoyl peroxide (bpo) 2.5% gel. (2011).
  16. Eichenfield, L. F. & Alió Sáenz, A. B. Safety and efficacy of clindamycin phosphate 1.2%-benzoyl peroxide 3% fixed-dose combination gel for the treatment of acne vulgaris: a phase 3, multicenter, randomized, double-blind, active- and vehicle-controlled study. J Drugs Dermatol 10, 1382–1396 (2011).
  17. Seidler, E. M. & Kimball, A. B. Meta-analysis comparing efficacy of benzoyl peroxide, clindamycin, benzoyl peroxide with salicylic acid, and combination benzoyl peroxide/clindamycin in acne. Journal of the American Academy of Dermatology 63, 52–62 (2010).
  18. NCT00787943. Study of two different 10.0% benzoyl peroxide creams for mild to moderate acne vulgaris. (2010).
  19. Tirado-Sánchez, A. & Ponce-Olivera, R. M. Efficacy and tolerance of superoxidized solution in the treatment of mild to moderate inflammatory acne. A double-blinded, placebo-controlled, parallel-group, randomized, clinical trial. J Dermatolog Treat 20, 289–292 (2009).
  20. De Arruda, L. H. F., Kodani, V., Bastos Filho, A. & Mazzaro, C. B. A prospective, randomized, open and comparative study to evaluate the safety and efficacy of blue light treatment versus a topical benzoyl peroxide 5% formulation in patients with acne grade II and III. An Bras Dermatol 84, 463– 468 (2009).
  21. Bissonnette, R. et al. Randomized study comparing the efficacy and tolerance of a lipophillic hydroxy acid derivative of salicylic acid and 5% benzoyl peroxide in the treatment of facial acne vulgaris. J Cosmet Dermatol 8, 19–23 (2009).
  22. Thiboutot, D. et al. An aqueous gel fixed combination of clindamycin phosphate 1.2% and benzoyl peroxide 2.5% for the once-daily treatment of moderate to severe acne vulgaris: assessment of efficacy and safety in 2813 patients. J Am Acad Dermatol 59, 792–800 (2008).
  23. Burkhart, C. G. & Burkhart, C. N. Treatment of acne vulgaris without antibiotics: tertiary amine- benzoyl peroxide combination vs. benzoyl peroxide alone (Proactiv Solution). Int J Dermatol 46, 89–93 (2007).
  24. Smith, S. & Kempers, S. A study of 5.5% benzoyl peroxide microsphere cream versus 6% benzoyl peroxide gel in the treatment of acne vulgaris. Cosmetic Dermatology 19, 537–542 (2006).
  25. Korkut, C. & Piskin, S. Benzoyl peroxide, adapalene, and their combination in the treatment of acne vulgaris. J Dermatol 32, 169–173 (2005).
  26. Ozolins, M. et al. Comparison of five antimicrobial regimens for treatment of mild to moderate inflammatory facial acne vulgaris in the community: randomised controlled trial. Lancet 364, 2188– 2195 (2004).
  27. Gollnick, H. P. M., Graupe, K. & Zaumseil, R.-P. Azelaic acid 15% gel in the treatment of acne vulgaris. Combined results of two double-blind clinical comparative studies. J Dtsch Dermatol Ges 2, 841–847 (2004).
  28. Milani, M., Bigardi, A. & Zavattarelli, M. Efficacy and safety of stabilised hydrogen peroxide cream (Crystacide) in mild-to-moderate acne vulgaris: a randomised, controlled trial versus benzoyl peroxide gel. Curr Med Res Opin 19, 135–138 (2003).
  29. Do Nascimento, L. V. et al. Single-blind and comparative clinical study of the efficacy and safety of benzoyl peroxide 4% gel (BID) and adapalene 0.1% Gel (QD) in the treatment of acne vulgaris for 11 weeks. J Dermatolog Treat 14, 166–171 (2003).
  30. Papageorgiou, P. P. & Chu, A. C. Chloroxylenol and zinc oxide containing cream (Nels cream) vs. 5% benzoyl peroxide cream in the treatment of acne vulgaris. A double-blind, randomized, controlled trial. Clin Exp Dermatol 25, 16–20 (2000).
  31. Dunlop, K. J. & Barnetson, R. S. A comparative study of isolutrol versus benzoyl peroxide in the treatment of acne. Australas J Dermatol 36, 13–15 (1995).
  32. Dogra, A., Sood, V. & Minocha, Y. Comparative evaluation of retinoic acid, benzoyl peroxide and erythromycin lotion in acne vulgarils. Indian J Dermatol Venereol Leprol 59, 243–246 (1993).
  33. Hunt, M. J. & Barnetson, R. S. A comparative study of gluconolactone versus benzoyl peroxide in the treatment of acne. Australas J Dermatol 33, 131–134 (1992).
  34. Hughes, B. R., Norris, J. F. & Cunliffe, W. J. A double-blind evaluation of topical isotretinoin 0.05%, benzoyl peroxide gel 5% and placebo in patients with acne. Clin Exp Dermatol 17, 165–168 (1992).
  35. Borglund, E. et al. Topical meclocycline sulfosalicylate, benzoyl peroxide, and a combination of the two in the treatment of acne vulgaris. Acta Derm Venereol 71, 175–178 (1991).
  36. Bassett, I. B., Pannowitz, D. L. & Barnetson, R. S. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med J Aust 153, 455–458 (1990).
  37. Cavicchini, S. & Caputo, R. Long-term treatment of acne with 20% azelaic acid cream. Acta Derm Venereol Suppl (Stockh) 143, 40–44 (1989).
  38. Flückiger, R., Furrer, H. J. & Rufli, T. Efficacy and tolerance of a miconazole-benzoyl peroxide cream combination versus a benzoyl peroxide gel in the topical treatment of acne vulgaris. Dermatologica 177, 109–114 (1988).
  39. Mills, O. H., Kligman, A. M., Pochi, P. & Comite, H. Comparing 2.5%, 5%, and 10% benzoyl peroxide on inflammatory acne vulgaris. Int J Dermatol 25, 664–667 (1986).
  40. Tucker, S. B., Tausend, R., Cochran, R. & Flannigan, S. A. Comparison of topical clindamycin phosphate, benzoyl peroxide, and a combination of the two for the treatment of acne vulgaris. Br J Dermatol 110, 487–492 (1984).
  41. Chalker, D. K., Shalita, A., Smith, J. G. & Swann, R. W. A double-blind study of the effectiveness of a 3% erythromycin and 5% benzoyl peroxide combination in the treatment of acne vulgaris. J Am Acad Dermatol 9, 933–936 (1983).
  42. Burke, B., Eady, E. A. & Cunliffe, W. J. Benzoyl peroxide versus topical erythromycin in the treatment of acne vulgaris. Br J Dermatol 108, 199–204 (1983).
  43. Bucknall, J. H. & Murdoch, P. N. N. Comparison of tretinoin solution and benzoyl peroxide lotion in the treatment of acne vulgaris. Current Medical Research and Opinion 5, 266–268 (1977).

Side Effects

Low-Medium
Low-medium side effects and adverse reactions

Acne.org's Real World Take

It’s been a staple of acne treatment for decades for a reason. When used properly it can completely clear the skin and it is widely available and affordable. Comes with annoying side effects for the first few weeks and can bleach fabric.

Reviews

3.5
20758 Reviews