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Everything you need to know about benzoyl peroxide
If you have acne-prone skin or struggle with breakouts, you may have heard about benzoyl peroxide, a skincare ingredient widely touted as an effective spot-clearing treatment. Or perhaps you haven't. Compared to other acne-tackling actives – such as salicylic acid – benzoyl peroxide is harder to find in products on UK shelves, which leads to confusion about how to access it, and why you'd want to over other more popular products.
Here, we've enlisted skincare experts to answer your most-asked questions about benzoyl peroxide, if you want to explore another way to break up with your breakouts.
What is benzoyl peroxide?
“Benzoyl peroxide is an organic peroxide that acts as a non-specific oxidising agent,” explains aesthetics expert Dr Emma Cunningham. “In simple terms, it works by releasing oxygen on the skin to help destroy bacteria.” Crucially, bacteria does not easily develop a resistance to benzoyl peroxide, as can be the case with antibiotics, meaning you can use it for more prolonged lengths of time if required.
The ingredient is mostly found in gel form for use as a spot treatment, but it can also be utilised in liquid washes or lotions and creams (often in lower concentrations). Some body products that directly target breakouts also contain benzoyl peroxide, as do a few exfoliating formulas designed to treat blocked pores.
Why exactly is benzoyl peroxide good for acne?
“All the best acne treatments work through multiple actions and benzoyl peroxide is no exception,” says the skin expert and founder of Dr Sam’s skincare, Dr Sam Bunting. “Firstly, it’s antiseptic, meaning it reduces the number of bacteria on the surface of your skin.”
It’s anti-inflammatory too (ideal for opposing acne, which is an inflammatory skin condition) and it helps unclog pores. “In practical terms, this means it reduces the appearance of angry red spots and prevents new ones from appearing.”
Another skincare authority, founder of Paula’s Choice Paula Begoun agrees. "Benzoyl peroxide is considered one of the most effective over-the-counter choices for reducing acne-causing bacteria and for combatting the inflammation that acne triggers. It can work quickly to get acne under control because it breaks down to oxygen on the skin, reducing the proliferation of the type of bacteria (known as C. acnes) that plays a key role in most forms of acne.”
Is benzoyl peroxide suitable for all skin tones?
Benzoyl peroxide is considered suitable for all skin tones, as although you might see the word 'peroxide' and think bleach, the ingredient is not known to have a lightening effect on the skin.
That said, it's especially important for anyone with darker skin to begin with the lowest available percentage. This is because any active that can trigger irritation or inflammation in high doses, benzoyl peroxide included, may increase your risk of post-inflammatory hyperpigmentation.
Furthermore, “benzoyl peroxide can bleach or discolour your hair, as well as clothes, towels and bedding, so you should be careful when applying the treatment," says the aesthetic doctor and founder of SAS Aesthetics, Dr Mahsa Saleki.
Can you use benzoyl peroxide when pregnant?
Benzoyl peroxide is not recommended for use if you are pregnant or breastfeeding, or for anyone taking certain prescriptions, which is why it's important to speak to the pharmacist when purchasing products containing it. You should also patch test the product prior to use, to ensure no allergic reaction takes place.
What percentage of benzoyl peroxide is best?
"Benzoyl peroxide is found in concentrations between 2.5 per cent and 10 per cent,” explains Begoun. “10 per cent strengths of benzoyl peroxide are often considered too irritating and might have side effects such as causing dry, flaky skin and possibly more breakouts. I recommend starting with a 2.5 per cent concentration applied twice daily and waiting a few weeks to see how your acne responds.”
Then, if you’re not seeing the results you want, “move to a 5 per cent concentration,” Begoun continues. “Studies have shown this strength can be just as effective as a 10 per cent concentration, but without the risk of visible side effects.”
Remember, whether you struggle with sensitivities or not, it’s important to follow the golden rule of skincare actives: start at the lowest percentage and gradually work up to avoid irritation.
Where can you get benzoyl peroxide in the UK?
Unlike other active acne treatments, such as retinoic acid (of which the buzzy tretinoin is a form of), you can get benzoyl peroxide without a prescription in the UK. However, that doesn’t mean you will commonly find it on the shelves.
Instead, “it’s mostly available over the counter with a pharmacist’s guidance,” explains Dr Bunting. She recommends the form marketed as Acnecide 5% gel, which is available at Boots and LookFantastic.
You will, however, need to speak to a doctor for a prescription if the benzoyl peroxide formula you want or need also contains an antibiotic, or if you require a higher dose.
What form of benzoyl peroxide should you choose?
“If you have mild acne, you can opt for a gel that contains about 5 per cent benzoyl peroxide [as above], or a face wash with approximately 2.5 per cent. Acid-based face washes are useful if you are experiencing outbreaks of whiteheads, for example,” says Dr Adam Friedmann, the leading consultant dermatologist at Stratum Dermatology Clinics. “If your acne is more severe, then benzoyl peroxide might be best prescribed as part of a mix of other treatments, such as a topical retinoid or antibiotic.”
If the latter is what you require, Dr Bunting recommends “Epiduo on prescription (it combines benzoyl peroxide with adapalene, which is a retinoid) or a formula that pairs benzoyl peroxide with an antibiotic, such as clindamycin or erythromycin, to amp up its antibacterial effect”. You will need to discuss these options with your GP or dermatologist.
How do you use benzoyl peroxide?
As a targeted treatment
“If you are using benzoyl peroxide in a higher percentage then the product should be applied directly to the area of skin affected,” guides Dr Saleki. “Wash the area with a cleanser and water, and pat your skin dry. Then, put a thin layer of gel on the affected areas and leave it to soak in,” she says. “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.”
As a wash-off treatment
“Lower percentages found in over-the-counter exfoliators or washes can be used up to twice daily as part of a regular skincare routine,” says Dr Saleki. “Wet your face or the area you want to treat and smooth on a small amount of the product. Keep the wash on your skin for no more than one-to-two minutes and then rinse your face thoroughly with water. Gently pat your skin dry. You'll usually use the wash once or twice a day.”
Dr Bunting recommends adds, “I usually recommend that benzoyl peroxide is used in the morning – with the use of a retinoid, such as tretinoin at night, which will help increase the absorption of benzoyl peroxide”.
What other skincare works well with benzoyl peroxide?
“Adding a 2 per cent BHA (also known as salicylic acid) leave-on exfoliant into your routine can make all the difference in the world, especially if you have persistent mild-to-moderate acne,” says Begoun. She recommends her anti-acne collection called Clear, which contains a BHA product. “Benzoyl peroxide can be very effective at treating both active acne lesions and preventing new ones, especially if combined with retinoids and/or salicylic acid,” agrees Dr Cunningham.
For the best results, you should also look at your wider skincare routine. “Beauty products are one of the most common causes of worsening adult acne,” says Dr Friedmann. “Moisturisers, sunscreen and especially make-up that may be too thick and oily can clog pores, resulting in acne. Switch to oil-free alternatives and apply sparingly.”
What should I avoid using with benzoyl peroxide?
“It used to be thought that you couldn’t use benzoyl peroxide with retinoids (such as retinol or retinoic acid) but research from 2010 showed that benzoyl peroxide is unlikely to degrade any form of vitamin A,” suggests Begoun.
However, you should avoid using benzoyl peroxide with lots of other actives to avoid overstimulating your skin, and check with your doctor or pharmacist if you have any questions or concerns. That’s especially true if you are prone to sensitivities, as benzoyl peroxide can cause dryness. “Do not use benzoyl peroxide with any other medicines that may have drying or irritating effects on your skin, including alcohol-based skincare products,” says Dr Saleki. Instead, swap these treatments (which could actually be doing more harm than good) for the benzoyl peroxide product you are given.
“Also try to avoid strong sunlight while using benzoyl peroxide gel too,” Dr Saleki continues. “Use an oil-free sunscreen with at least SPF 30.”
If you’re confused about treatment options, you can get further advice via an online acne assessment, available from Stratum Dermatology Clinics, or access these other online dermatology services if you can't see a dermatologist in person.
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