Can you use benzoyl peroxide with niacinamide?

What does each ingredient do?

Benzoyl peroxide reduces acne causing bacteria and helps with spots and blocked pores. Niacinamide is a form of vitamin B3 with anti inflammatory, moisturizing and soothing effects. The ingredients have different roles: benzoyl peroxide treats acne, while niacinamide can support an acne routine rather than replace the treatment. Both are used for inflammatory acne, meaning red, swollen and sore blemishes.23

Does adding niacinamide make benzoyl peroxide work better?

For adults with mild to moderate facial acne, adding 5% niacinamide to 2.5% benzoyl peroxide produced a greater reduction in blackheads and whiteheads over 12 weeks than benzoyl peroxide with a plain cream. Oil levels also fell faster with niacinamide. There was no significant extra improvement in inflamed pimples, redness after acne or dark marks between the two routines. Niacinamide is an optional addition, not a compulsory promotion for your bathroom shelf.1

How should you use them together?

Benzoyl peroxide comes in washes and gels that stay on the skin, so the directions depend on the format. A wash comes off and a leave on gel stays on, despite both answering to the same ingredient name.2

1. 1Wash your hands. For a leave on gel, gently clean and dry your skin, then apply a thin layer to the affected area.
2. 2For a gel wash, wet the affected skin, use a small amount for 1 to 2 minutes, then rinse and pat dry. Follow your product's directions if they differ.
3. 3Apply niacinamide as its product directs. The tested routine used benzoyl peroxide before washing, rinsed it off after 10 minutes, then applied niacinamide cream. That sequence is not a universal instruction for every benzoyl peroxide product.
4. 4Wash your hands after using benzoyl peroxide. Use sunscreen during the day and keep benzoyl peroxide away from clothing, fabrics and hair because it can bleach them.

Start with the lowest benzoyl peroxide strength. Usual use is once or twice daily, following the packet; the tested combination was used twice daily. If dryness is a problem, use a fragrance free, water based moisturizer.124

What if your skin is sensitive?

Benzoyl peroxide can cause irritant contact dermatitis, meaning inflammation from damage to the skin barrier. People with eczema are particularly susceptible. Strength, amount and frequency of exposure all influence irritation, and several irritating products can have a cumulative effect. Niacinamide's soothing properties are not a reason to push through burning, cracking or a rash. Avoid the irritating products and use moisturizer if irritation develops.5

Use benzoyl peroxide less often if it causes dryness or peeling, and ask a pharmacist or doctor about symptoms that persist or bother you. Stop using it and seek emergency help for difficulty breathing or a swollen throat or tongue. Do not apply benzoyl peroxide to infected or broken skin.2

If you already use prescription acne treatments, check before adding benzoyl peroxide. Other treatments that cause dryness or peeling need a pharmacist's or doctor's approval. During pregnancy, benzoyl peroxide can usually be used, but check first; breastfeeding also needs advice, and benzoyl peroxide should not be applied to the breasts.2

When should you expect results?

Benzoyl peroxide usually starts working within four weeks. Acne treatment plans often need at least six to eight weeks before fewer breakouts become noticeable. Seek medical advice if acne worsens or has not improved after 12 weeks. See a doctor sooner for moderate or severe acne, deep lumps called nodules, or cysts, which need treatment to reduce scarring.246

How should you store benzoyl peroxide?

Follow the package storage instructions, generally room temperature or cooler. Benzoyl peroxide can break down into benzene with heat or prolonged storage. The American Academy of Dermatology recommends replacing products every 10 to 12 weeks and discarding products exposed to temperatures above 78 degrees Fahrenheit.7