Can I use benzoyl peroxide and salicylic acid together?

What the evidence supports

Benzoyl peroxide and salicylic acid are both recommended topical acne options, and acne care can use topical treatments that work in different ways. That is teamwork, not a standing invitation for every bottle to move in together.3

One 10 week study tested a specific system in 82 adolescents aged 11 to 17 with mild to moderate facial acne. It paired a 2 percent salicylic acid cleanser used twice daily and a 2 percent salicylic acid toner used once daily with a solubilized 5 percent benzoyl peroxide gel used twice daily. Compared with a different benzoyl peroxide and clindamycin regimen, the system reduced noninflammatory lesions more at weeks 2 and 4, and had comparable effects on inflammatory lesions at all measured times. Those results apply to the tested system and group, not every pair of products or every person's skin. The study tested one fixed routine, not an open invitation for every bottle on the shelf.2

How to use both

Do not start the combination by guessing at an order or frequency. Benzoyl peroxide comes as either a leave on gel or a wash that you rinse off, so follow the directions for the exact form you have.1

1. 1Ask a doctor or pharmacist whether your exact benzoyl peroxide and salicylic acid products can be used together.
2. 2For a leave on benzoyl peroxide gel, wash your hands, gently clean and dry your skin, apply a thin layer to the affected area, then wash your hands again.
3. 3For a benzoyl peroxide wash, wet the area, use a small amount for 1 to 2 minutes, rinse it off, pat your skin dry and wash your hands.
4. 4Start benzoyl peroxide at the lowest strength. It is usually used once or twice a day, but follow the packet or leaflet for your product. Using more than directed will not make it work faster.
5. 5Follow the salicylic acid product's own directions. The twice daily cleanser and once daily toner in the study were part of that specific system, not general directions for other products.

Benzoyl peroxide usually starts to work within 4 weeks. If acne gets worse or has not improved after 12 weeks, speak with a pharmacist or see a doctor. The study reported an earlier difference in noninflammatory lesions at weeks 2 and 4, but only for its tested system compared with its study treatment; that is not a promised timeline for another product combination.1

What to watch for

Benzoyl peroxide can cause hot, itchy or painful skin, redness, dryness or peeling. These effects often improve after a few days or when the product is used less often. Contact a pharmacist or doctor if side effects bother you or do not go away. Benzoyl peroxide can make skin more sensitive to sunlight, so use sunscreen and avoid prolonged sun exposure, sunbeds and sunlamps. Keep it off hair and fabrics because it can bleach them.1

Do not use benzoyl peroxide on infected or broken skin, and keep it away from your eyes and mouth. If it gets in your eyes, rinse with plenty of water. If you swallow it, get medical help.1

Pregnancy, breastfeeding and other acne treatments

Over the counter benzoyl peroxide and salicylic acid are generally considered safe during pregnancy. Benzoyl peroxide can usually be used during pregnancy, but check with a doctor first. If breastfeeding, ask a doctor or pharmacist before using benzoyl peroxide, and do not apply it to your breasts. If you use other acne medicines that irritate or dry the skin, get professional advice before adding benzoyl peroxide.14

Get emergency help for signs of a serious allergic reaction, such as swelling of the throat or tongue, a raised itchy rash or difficulty breathing.1