Benzoyl Peroxide

Benzoyl Peroxide is a common therapy recommended as first line treatment for acne.

Benefits of Benzoyl Peroxide

Benzoyl Peroxide works to destroy the acne causing bacteria that create blackheads, whiteheads, and pimples. Benzoyl Peroxide works in three ways, killing bacteria, reducing inflammation, and unplugging blocked pores.
  • Reduces comedones, papules and pustules, and is suitable for long term maintenance therapy

Treatment mild acne

Benzoyl peroxide has a good track record of safety and effectiveness for the treatment of mild acne. In some cases, effectiveness can be increased if used in combination with antibiotic or retinoid creams.

Benzoyl peroxide is considered as first line treatment for mild acne. Strong evidence from scientific studies show that benzoyl peroxide reduces both inflammatory and non-inflammatory lesions.

Benzoyl peroxide in concentrations of 2.5%, 5% and 10% have been shown to be equally effective however higher concentrations have been linked with more side effects.

Moderate acne responds well to combination therapy with benzoyl peroxide, antibiotics and/or retinoids.

Benzoyl peroxide combined with a topical antibiotic, such as clindamycin, has been shown to be effective in large randomised controlled clinical trials. A clinical trial compared the safety of the combinations clindamycin/benzoyl peroxide and adapalene/benzoyl peroxide in patients with mild-to-moderate acne. Results showed that clindamycin/benzoyl peroxide gel had less side effects.

Benzoyl peroxide and topical azelaic acid have also shown to reduce inflammatory and non-inflammatory lesions compared with placebo, but can cause itching, burning, stinging, and redness of the skin.

There is some evidence of increased effectiveness when benzoyl peroxide is used alongside topical tretinoin (a retinoid). A clinical trial testing tretinoin lotion 0.05%, benzoyl peroxide 5% and 10% was carried out in 250 patients suffering from acne. The results showed that tretinoin applied in the morning and benzoyl peroxide applied at night was the most effective with minimal side effects.


Betty Anne Johnson MD, PhD & Julia R. Nunley MD (2000) Topical therapy for acne vulgaris, Postgraduate Medicine, 107:3, 69-80, DOI: 10.3810/pgm.2000.03.945

Mohd Nor NH, Aziz Z. A systematic review of benzoyl peroxide for acne vulgaris. Journal of Dermatological Treatment 2013; 24(5): 377-386.

National Center for Biotechnology Information. PubChem Compound Database; CID=7187, (accessed Sept. 27, 2017).

Chalker DK, Shalita A, Granham Smith J, et al. A double-blind double-blind group comparison study of the effectiveness of a 3% erythromycin and 5% benzoyl peroxide combination in the treatment of acne vugaris. J Am Acad Dermatol 1983; 9: 933-6 (2017). Acne vulgaris - NICE CKS. [online] Available at:!scenario [Accessed 29 Sep. 2017].

Dreno, B. (2004). Topical Antibacterial Therapy for Acne Vulgaris. Drugs, 64(21), pp.2389-2397.

Thiboutot, D. (2000) New treatments and therapeutic strategies for acne. Archives of Family Medicine9(2), 179-187.

Purdy, S. and de Berker, D. (2011) Acne vulgaris.Clinical Evidence. BMJ Publishing Group Ltd.


Gonzalez, P., Vila, R. and Cirigliano, M. (2012). The tolerability profile of clindamycin 1%/benzoyl peroxide 5% gel vs. adapalene 0.1%/benzoyl peroxide 2.5% gel for facial acne: results of a randomized, single-blind, split-face study. Journal of Cosmetic Dermatology, 11(4), pp.251-260.

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Why I prescribe Benzoyl peroxide
“I believe benzoyl peroxide is a fantastic acne-fighting ingredient and the beauty of it is that it can be used in many forms, creams, gels, face washes. It is a wonderful team player with other ingredients such as our antibiotics or retinoids and really amplifies their effectiveness. It helps reduce inflammation and fight that acne causing bacteria.”

Dr Baldeep Syan

GP, Special Interest Dermatology



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Benzoyl Peroxide FAQs

What is Benzoyl Peroxide?
Benzoyl peroxide is part of the organic peroxide family with antibacterial and anti-inflammatory features. It can be found in the form of soaps, gels, washes and lotions with concentrations ranging from 1% to 10%. Gel formulations of benzoyl peroxide may be preferred over creams and lotions. It can sometimes be used in combination with other chemicals to help with dry and oily skin and/or with an antibiotic cream such as clindamycin and erythromycin. There have been numerous scientific trials proving effectiveness and safety.
How does Benzoyl Peroxide work?
When applied to the skin, it breaks down and releases oxygen reducing the growth of propionibacterium acnes, a bacteria associated in the formation of acne. It also increases cell turnaround, removing both mild blackheads and whiteheads (comedones) in the skin.
How should Benzoyl Peroxide be used?
It should be applied to the entire affected area, usually in the morning and evening. It can be sometimes used in combination with a retinoid or topical antibiotic.
What are the side effects of Benzoyl Peroxide?
All medications have some side effects so it is important to be aware, however do not be alarmed. The most common side effect is skin irritation. Other side effects include erythema, peeling, and dryness but these can usually be reduced by using lower concentrations.