Benzoyl peroxide 5%: what it does and how to use it

Is your 5% product a gel or a wash?

Benzoyl peroxide comes as a gel you leave on and a gel wash you rinse off, which is a lot of responsibility for one extra word. A gel and a gel wash are different formats, despite their names making only the smallest possible effort to distinguish them, as if rinsing were a minor editorial detail. Some products are for the face only; others cover the face, chest and back, which is more geography than the word gel usually volunteers. Follow the directions for your particular product.1

How do you apply benzoyl peroxide 5% gel?

1. 1Wash your hands, then gently clean and dry the skin.
2. 2Apply a thin layer over the entire affected area, rather than covering only individual spots. Keep the gel away from your eyes, lips and mouth.
3. 3Begin with one application daily if using Face Reality Acne Med 5%. Increase only if needed and allowed by your label or doctor.
4. 4Wash your hands afterwards.
5. 5Apply sunscreen after the gel if going outside. Avoid unnecessary sun exposure.

Application frequency differs between products. General 5% aqueous gel directions are once or twice daily. Face Reality Acne Med 5% allows a gradual increase to two or three applications daily, while the Rugby gel repackaged by NuCare lists one to three daily applications. Do not treat the highest frequency on another brand's label as your starting schedule. These directions specify frequency rather than a required morning or evening application.234

For a gel wash, wet the affected skin, wash with a small amount for 1 to 2 minutes, then rinse and pat dry. Wash your hands before and afterwards.1

How long does it take to work?

Benzoyl peroxide usually starts working within 4 weeks. Speak to a pharmacist or GP if acne worsens or has not improved after 12 weeks. Applying more than directed does not make treatment work faster and increases the risk of side effects.1

What if your skin becomes dry or irritated?

Possible reactions include dryness, redness, burning, itching, peeling and swelling. For mild irritation, use the product less often or consider a lower concentration. Face Reality Acne Med 5% directs you to reduce bothersome dryness or peeling to once daily or every other day; the Rugby gel directs you to reduce to once daily. Stop if irritation becomes severe and ask a doctor. Seek advice if irritation continues after stopping.34

The Face Reality and Rugby 5% gels say not to use them on very sensitive skin or if you are sensitive to benzoyl peroxide. Keep the medicine away from hair and dyed fabrics, including clothing and carpet, because it can bleach them. If gel gets into your eyes, flush thoroughly with water. If swallowed, get medical help or contact a poison control centre immediately.34

Can you use it with other acne treatments?

Adding another acne medicine applied to the skin can increase dryness and irritation, including when used immediately after benzoyl peroxide. If irritation occurs, use only one acne medicine unless your doctor directs otherwise. For Face Reality Acne Med 5%, stop both the gel and sunscreen and ask a doctor if irritation or sensitivity develops when following its sunscreen directions.34

Wash acne prone skin twice daily with a gentle cleanser, remove makeup at the end of the day, and choose skincare and makeup labelled noncomedogenic, meaning designed not to clog pores. Do not scrub, pick or squeeze spots: scrubbing can worsen irritation, and picking can cause scars.5

Who should check before using it?

Most adults and children aged 12 or older can use benzoyl peroxide. Do not apply it to infected or broken skin. During pregnancy it can usually be used, but check with your doctor. If breastfeeding, check with a pharmacist or doctor first and avoid applying it to the breasts.1

A serious allergic reaction is rare. A swollen throat or tongue, an itchy raised rash, or difficulty breathing requires emergency help; call 999 in the UK.1

See a GP if you have many spots, deep painful lumps, scarring, or acne affecting your mental health. Hot, swollen or red skin can indicate infection and also needs medical assessment. Redness can be harder to see on brown and black skin. A GP can offer prescription treatment or refer you to a dermatologist.5

Is benzoyl peroxide 5% available over the counter?

Yes. A 5% aqueous gel is available over the counter in the UK, and the two US 5% gels discussed here are also nonprescription medicines. An acne treatment can be a medicine without requiring a prescription. In Canada, benzoyl peroxide in nonprescription acne treatments must be at a concentration of 5% or less.2346

How do you use benzoyl peroxide gel 2.5%?

General gel guidance applies: clean and dry the skin, spread a thin layer over the affected area, and wash your hands afterwards. Use your 2.5% product's own directions for frequency rather than borrowing a 5% brand's schedule. Start with the lowest strength available to assess tolerance.1

What is benzoyl peroxide gel 2.5% used for?

It is an acne treatment with a lower benzoyl peroxide concentration than 5%. Ask a pharmacist about current options: the Canadian registration for 2.5 Benzagel 2.5% Acne Gel was cancelled in 1999.7