1. About benzoyl peroxide
Benzoyl peroxide is used to treat acne. It works as an antiseptic to reduce the number of germs (bacteria) on the surface of your skin. It comes as a gel or face wash containing 5% benzoyl peroxide. This is available to buy from pharmacies under the brand name Acnecide.
Benzoyl peroxide is sometimes mixed with potassium hydroxyquinoline sulfate. This is an “antimicrobial” ingredient that kills micro-organisms on your skin. It’s sold in pharmacies as Quinoderm cream.
Some benzoyl peroxide products are available on prescription only. This is because they contain other active ingredients such as antibiotics or retinoids (exfoliants).
Many popular skincare brands also make products that contain benzoyl peroxide, but at a lower strength. These are available to buy in pharmacies, supermarkets and shops. Brands include Clean & Clear, Neutrogena and Clearasil.
2. Key facts
- Benzoyl peroxide 5% takes around 4 weeks to start working.
- You’ll usually use it 1 or 2 times a day.
- The most common side effect is skin irritation. It is better to use it less often at first, then build up as your skin gets used to it.
- Pharmacy brands include Acnecide 5% gel and Acnecide Wash 5%.
- Benzoyl peroxide is also an ingredient in Duac Once Daily (with clindamycin, an antibiotic) and Epiduo gel (with adapalene, a retinoid).
3. Who can and cannot use benzoyl peroxide
Most adults and children over 12 years old can use benzoyl peroxide. Benzoyl peroxide is not suitable for some people.
To make sure benzoyl peroxide is safe for you, tell your doctor before using this medicine if you:
- are allergic to benzoyl peroxide or other medicines.
- have damaged or broken skin where you need to use the treatment.
- have very bad acne with nodules (large, hard lumps that build up beneath the surface of the skin and can be painful) or cysts (large, pus-filled lumps that look similar to boils). These need to be treated by a doctor to avoid scarring.
4. How and when to use it
- Benzoyl peroxide is for use on your skin only.
- Always wash your hands before and after using this medicine.
- If your skin becomes dry or starts peeling, try using benzoyl peroxide less often. Put it on once a day or once every 2 days, until your skin gets used to it.
- Benzoyl peroxide can bleach or discolour your hair, as well as clothes, towels and bedding. Keep it away from hair and coloured fabrics.
How to use benzoyl peroxide 5% gel
- Wash the affected area with a mild skin cleanser and water.
- Gently pat your skin dry.
- Put a thin layer of gel on all the affected areas. If your whole face has acne, use a strip of gel (2.5cm long) each time.
You’ll usually use the gel once or twice a day. If you have sensitive skin, use the gel once a day, before going to bed.
Try to avoid strong sunlight while using benzoyl peroxide gel. Use an oil-free sunscreen, or a moisturiser or foundation with added SPF30. In stronger sunlight, use SPF30 or above. Ask a pharmacist to help you pick a sunscreen that’s right for your skin type.
How to use benzoyl peroxide 5% wash
- Wet the area you want to treat.
- Place a small amount of the product onto your hands.
- Smooth it onto the affected area.
- Keep the wash on your skin for no more than 1 to 2 minutes.
- Rinse your face thoroughly with water.
- Gently pat your skin dry.
You’ll usually use the wash 1 or 2 times a day.
How long will I use it for?
It depends on how quickly your condition improves.
Benzoyl peroxide will usually start to work within 4 weeks, but once your acne is under control you may want to keep using it to stop your acne coming back.
What if I forget to use it?
It does not matter if you forget to use benzoyl peroxide. When you remember, start using it again once or twice a day in the same way as before.
What if I use too much?
- If you use too much benzoyl peroxide, your skin may become irritated. Wash off as much as you can and wait for the irritation to go away.
- When your skin has calmed down again, you can start using benzoyl peroxide again. Be careful to follow the instructions on the package.
Keep benzoyl peroxide away from your eyes. If you get the gel or wash in your eyes, rinse thoroughly with lukewarm water for a few minutes or until it stops stinging.
5. Side effects
Like all medicines, benzoyl peroxide can cause side effects, although not everyone gets them.
Common side effects
These common side effects happen in more than 1 in 10 people. Talk to a doctor or pharmacist if these side effects bother you or do not go away:
- dry skin
- red or peeling skin
- burning or stinging (skin irritation)
Serious side effects
These serious side effects are rare and happen in less than 1 in 1,000 people. Stop using benzoyl peroxide if:
- the skin that you’re treating becomes swollen
- you get blisters on your skin
If your symptoms do not get better within a couple of days or if they get worse at any time, contact a doctor straight away.
Serious allergic reaction
In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to benzoyl peroxide.
Immediate action required:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you’re wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of benzoyl peroxide. For a full list, see the leaflet inside your medicine packet.
- You can report any suspected side effects to the UK Safety Scheme
6. How to cope with side effects
What to do about:
- dry skin – apply a moisturiser and lip balm regularly (the best type of moisturiser is an oil-free face moisturiser for sensitive skin). Try to take shorter showers, using warm water rather than hot.
- red or peeling skin – try using the gel or wash less often, or stop using it for a few days until the irritation goes away, then start again. Do not use other products on your skin in the meantime. Speak to a doctor if your symptoms do not get better or are severe.
- burning or stinging (skin irritation) – try using the gel or wash less often (once a day instead of twice, or every other day). It might help to stop using the gel for a few days until the irritation goes away, then start again. If the irritation does not go away after this time, stop using it and speak to a doctor.
7. Pregnancy and breastfeeding
It’s usually safe to use benzoyl peroxide during pregnancy and while breastfeeding.
Benzoyl peroxide and breastfeeding
Although it’s generally OK to use benzoyl peroxide when you’re breastfeeding, do not use it on your chest area and wash your hands before touching your baby. This is so your baby does not come into contact with it.
Tell a pharmacist or doctor if you’re trying to get pregnant, already pregnant or breastfeeding
8. Cautions with other medicines
Some products and medicines can irritate your skin if you use them while you’re treating your skin with benzoyl peroxide gel or wash.
Do not use benzoyl peroxide with any other medicines that may have drying or irritating effects on your skin. These include alcohol-based skincare products. Always check the ingredients on the label and choose products for sensitive skin.
Do not use other benzoyl peroxide products or other acne medicines (such as isotretinoin), unless your doctor or pharmacist says it’s OK. It may cause your skin to become very sore.
Mixing benzoyl peroxide with herbal remedies and supplements
There’s very little information about taking herbal remedies and supplements while using benzoyl peroxide.
Tell your doctor or pharmacist if you are taking any other medicines, including herbal remedies, vitamins or supplements.
9. Common questions
- How does it work?
Benzoyl peroxide attacks the bacteria on your skin. It also helps to unclog pores by removing dead skin to prevent blockages. This treats existing acne and may help prevent new spots. It works best when you use it regularly.
- How long does it take to work?
Benzoyl peroxide usually takes about 4 weeks to start working. It can take up to 2 to 4 months for the treatment to have its full effect.
- What can I do if benzoyl peroxide does not work?
Speak to a doctor if your skin does not improve with benzoyl peroxide, or if acne is making you feel very unhappy.
They may recommend antibiotics or stronger creams. These treatments are only available on prescription.
Is it safe to take for a long time?
It is generally OK to use Benzoyl peroxide for a long time, as long as you do not have any serious side effects.
When you stop using benzoyl peroxide you may find that acne comes back. You may want to keep using it to keep acne under control. You may find that using it less often, such as once every other day, is enough to control acne.
- Are there other acne treatments I can buy?
Benzoyl peroxide is usually one of the first treatments recommended for mild to moderate acne.
However, there are other types of acne creams, lotions and gels available to buy from a pharmacy. These have different active ingredients including:
Azelaic acid cream – attacks the bacteria on your skin. It also reduces the growth of hard skin cells which block your pores and can cause spots.
Glycolic acid or lactic acid – helps remove dead skin cells and reduce inflammation. It improves the appearance of acne scars and makes pores look smaller.
Salicylic acid – helps prevent pores from becoming clogged.
Sulphur (or sulfur) – removes dead skin cells that cog pores and helps remove excess oil. It is usually combined with other active ingredients.
- Are there prescription treatments for acne?
Prescription-only treatments for acne include:
antibiotics creams, gels, solutions or lotions (such as clindamycin) – attack the bacteria on your skin.
antibiotics tablets or capsules (such as erythromycin or doxycycline) – attack the bacteria on your skin.
retinol cream or gel (such as adapalene) – affects the growth of cells which helps to unblock pores.
oral contraceptives (combined oral contraceptives, progesterone only, or cyproterone with ethinylestradiol) – affect the levels of hormones in your body. This may help to prevent you getting oily skin which can cause spots.
isotretinoin capsules – you will need to see a specialist doctor before you can receive treatment with isotretinoin. It is very effective and works on all 4 causes of acne – oily skin, clogged pores, too much bacteria and inflammation.
- Can I drink alcohol with it?
Yes, it is OK to drink alcohol while you're using benzoyl peroxide.
- Is there any food or drink I need to avoid?
There is no food or drink you need to avoid while using benzoyl peroxide. There is no evidence that eating chocolate or greasy foods causes spots. However, eating a healthy, balanced diet is recommended because it's good for your heart and your health in general.
- Will it affect my contraception?
No, it will not affect any type of contraception, including the combined pill and emergency contraception.
- Will it affect my fertility?
There's no clear evidence that using benzoyl peroxide will affect male or female fertility.
- Can I drive or ride a bike?
Benzoyl peroxide will not affect your ability to drive or ride a bike.
- Can lifestyle changes help acne?
There are some self-help tips that you may find useful:
-do not wash the affected areas of skin more than 2 times a day. Frequent washing can irritate the skin and make symptoms worse
-wash the affected area with a mild soap or cleanser and lukewarm water. Very hot or cold water can make acne worse
-do not try to “clean out” blackheads or squeeze spots. This can make them worse and cause permanent scarring
-avoid using a lot of make-up or cosmetics. Use water-based products that are described on the label as non-comedogenic (this means the product is less likely to block the pores in your skin)
-completely remove make-up before going to bed
-if dry skin is a problem, use a fragrance-free, water-based moisturiser (emollient)
-regular exercise cannot improve acne, but it can boost your mood and improve your self-esteem. Shower as soon as possible once you finish exercising, as sweat can irritate acne
-wash your hair regularly and try to avoid letting your hair fall across your face