Benzoyl peroxide gel: how to use it for acne

What does benzoyl peroxide treat?

Acne starts when pores become blocked with oil and skin cells. A pore opens into a follicle containing a hair and an oil gland. The blockage forms a plug: a whitehead if its top is white, or a blackhead if its top is dark. Bacteria trapped inside the plug can trigger an immune reaction and pimples. Benzoyl peroxide is one of the acne medicines available without a prescription. Deep, painful cysts and acne that leaves scars need medical assessment rather than repeated attempts with shop bought treatments.2

Which kind of gel do you have?

Plain benzoyl peroxide comes as a gel you leave on or a gel wash you rinse off; combination gels also contain another acne medicine. A gel wash goes down the drain, while a gel stays on your skin; the word gel is doing rather a lot of administrative work.1

How do you use benzoyl peroxide gel?

1. 1Wash your hands.
2. 2Gently clean and dry the affected skin.
3. 3Apply a thin layer of gel to the affected area and leave it to absorb.
4. 4Wash your hands afterwards.

Plain benzoyl peroxide is usually used once or twice daily; follow your packet. For a gel wash, wet the skin, wash with a small amount for one to two minutes, then rinse and pat dry. Some products are only for the face, while others also suit the chest and back.1

What should the rest of your routine look like?

Wash acne prone skin with a gentle cleanser twice daily and remove makeup at the end of the day. Avoid scrubbing and picking or squeezing spots, which can cause scars. Look for noncomedogenic skincare and makeup, meaning products intended not to clog pores; the useful part of the label is not the promise of a new personality. For body acne, loose, breathable clothing is useful, particularly during exercise or sweating.3

How long does it take, and what side effects should you expect?

Acne treatment often takes six to eight weeks to produce a response, and acne can flare again. Apply acne medicines sparingly and follow their directions rather than increasing the amount. Redness, dryness and excessive peeling can occur with topical acne treatments. Benzoyl peroxide preparations can also bleach or discolor towels and clothing, so avoid contact with fabrics.2

Use plain benzoyl peroxide less often if irritation develops, and seek advice for persistent side effects. Use sunscreen and avoid sunbeds. Keep it away from eyes, the mouth, infected skin and cuts. Get emergency help for breathing difficulty or a swollen tongue or throat. Seek advice if acne worsens or remains unimproved after 12 weeks.1

See a doctor sooner for lots of spots, deep or painful lumps, scarring, or acne affecting your mental health. Hot, swollen skin can indicate infection and also needs assessment. Redness can be harder to see on brown and black skin. A doctor can offer prescription treatment or refer you to a dermatologist, a doctor who specialises in skin.3

What is benzoyl peroxide gel with clindamycin?

Clindamycin is an antibiotic. A prescription gel containing 1% clindamycin and 5% benzoyl peroxide treats acne. In two trials, this combination produced greater improvement than either ingredient alone when investigators assessed treatment after 10 weeks. Follow your prescriber's directions rather than borrowing the schedule for plain benzoyl peroxide. In those trials, treatment was applied twice daily to the entire face, 15 minutes after the washed face was thoroughly dry. Moisturizer was used as needed, and nonmedicated makeup was allowed one hour after application.4

The 1% clindamycin and 5% benzoyl peroxide gel must not be used by people allergic to its components or lincomycin, or with a history of regional enteritis, ulcerative colitis or antibiotic associated colitis. These are inflammatory bowel conditions. Stop treatment and seek medical advice for significant diarrhea, especially bloody diarrhea or severe abdominal cramps. Topical clindamycin can be absorbed through the skin and has been associated with serious bowel inflammation. Do not combine this gel with erythromycin products or add other topical acne treatments unless your doctor directs you to.5

How do you use adapalene and benzoyl peroxide gel?

Epiduo combines adapalene with benzoyl peroxide. Adapalene is a retinoid, a medicine related to vitamin A, that increases skin cell turnover to unblock pores and reduce blackheads and spots.67

Apply adapalene containing gel thinly across the acne affected area at bedtime, not just to individual spots. Clean and dry the skin first, then wash your hands afterwards. Start on a small test area. Two to three applications weekly can be a starting schedule, increasing towards nightly use as tolerated. Wait until the gel has absorbed before applying moisturizer or cosmetics. Avoid broken, sunburnt or eczema affected skin, eyelids and lips. Use SPF 50 sunscreen and protective clothing, and avoid sunbeds. Most people need at least a couple of months for improvement. Burning, redness and dryness tend to improve after two to four weeks. Reduce frequency or pause for irritation; stop and see a doctor if it is severe or persistent. Avoid other retinoids, salicylic acid, glycolic acid and abrasive or strongly drying products.7

Can you use it during pregnancy or breastfeeding?

Plain benzoyl peroxide can usually be used during pregnancy, but check with your doctor. During breastfeeding, check first and avoid applying it to your breasts. Adapalene containing gels are different: stop if you think you are pregnant, use contraception during treatment, and check with your doctor about breastfeeding.17

What is benzoyl peroxide gel IP used for?

Benzoyl peroxide gel is an acne treatment. For a tube marked IP, follow its own strength and application directions rather than substituting instructions from another product.1