Introduction

Acne, a common dermatological concern affecting individuals of all ages, is the type of annoying skin condition that seems to always be in search of effective treatment solutions. For years now, the two most used active ingredients for managing acne are benzoyl peroxide and salicylic acid. In this article, we will delve into the world of acne treatment by deciphering the nuances of these well-known anti-acne skincare ingredients to answer some of the questions on the minds of today’s acne sufferers to help empower them on their acne management journey.

How Do Benzoyl Peroxide and Salicylic Acid Work to Treat Acne?

Benzoyl Peroxide [1]

Benzoyl peroxide is a formidable weapon in the fight against acne, exerting its efficacy through a multifaceted approach. Upon application, benzoyl peroxide penetrates deep into the skin’s pores, where it unleashes a dual assault on acne-causing bacteria. Its ability to generate free radicals enables it to effectively kill acne causing Cutibacterium acnes (C. acnes) present in the skin’s pores, a major factor implicated in acne formation. This antimicrobial action not only targets existing blemishes but also helps to prevent the formation of new ones, thereby curing the cycle of acne recurrence.

In addition, benzoyl peroxide functions as a potent keratolytic agent by helping to exfoliate (remove) dead skin cells which, when mixed with sebum (oil) leads to the clogging of pores and the uncontrolled growth of acne-triggering C. acnes. By promoting skin cell turnover and facilitating the shedding of dead skin cells, benzoyl peroxide helps to unclog pores and prevent the accumulation of debris that can lead to acne formation. This dual action not only reduces inflammation and redness associated with acne but also promotes clearer, healthier skin over time.

Although benzoyl peroxide has been considered a perennial “gold standard” ingredient for treating acne, a word of caution regarding its use must be provided. A recent report by an independent US laboratory (Valisure) has shed light on the potential for benzene (a known carcinogen) exposure associated with its use. In addition, benzoyl peroxide has also been found to negatively affect both the skin barrier and skin microbiome.

One of the primary ways benzoyl peroxide damages the skin barrier is through its generation and release of oxygen radicals which can penetrate the skin and trigger oxidative stress. This oxidative stress can damage the lipid portion of the skin barrier which helps skin retain moisture and protect the body against environmental irritants. As a result, prolonged use of benzoyl peroxide can disrupt the skin barrier and lead to dryness, redness, and increased skin sensitivity.

Benzoyl peroxide’s antimicrobial properties can also disrupt the delicate balance of the skin microbiome which represents the diverse community of microorganisms that live on the skin’s surface and play a crucial role in maintaining skin health. These microorganisms help regulate inflammation, protect against pathogens, and support the skin barrier. However, because benzoyl peroxide indiscriminately targets both harmful (acne-causing) and beneficial (skin barrier supporting) bacteria on the skin, its prolonged use can lead to a disruption in microorganism diversity/balance which has been linked to various skin conditions such as acne, eczema, and rosacea.

Lastly, because of its inherently harsh/aggressive chemical profile, benzoyl peroxide can also exacerbate existing skin conditions and cause irritation. Its aggressive exfoliating properties can strip away the outer layer of the skin leading to increased sensitivity, irritation, and inflammation. This irritation can further compromise the skin barrier and exacerbate acne symptoms, creating a vicious cycle of inflammation and damage.

Salicylic Acid [2]

Salicylic acid represents another cornerstone in the treatment of acne due to its impressive ability to penetrate the skin and address key factors that contribute to acne formation. Chemically referred to as a beta-hydroxy acid (BHA), salicylic acid exhibits powerful exfoliating properties, effectively penetrating the pores to dissolve the bonds between dead skin cells. By facilitating the shedding of these cells, salicylic acid helps to unclog pores and prevent the formation of comedones (i.e., clogged pores) that can lead to acne. This exfoliating action not only reduces the likelihood of acne breakouts, but also promotes a smoother (less flaky) skin texture.

In addition, salicylic acid also possesses anti-inflammatory properties, making it especially effective at calming the redness and swelling typically associated with acne flare-ups. By mitigating inflammation, salicylic acid helps to alleviate the discomfort and unsightliness associated with acne lesions, thereby promoting a clearer looking complexion. Moreover, salicylic acid’s ability to help regulate sebum (oil) production by the skin offers an added benefit when it comes to acne flare-up management by helping to control excess oil production and minimize pore congestion.

At the end of the day, the difference between salicylic acid and benzoyl peroxide comes down to their respective modes of action. Whereas benzoyl peroxide is more aggressive in attacking acne via its “oxidation” mode of action, salicylic acid is much gentler as it works to disintegrate the debris (dead skin plus sebum) responsible for clogging pores and trapping acne bacteria.

What’s More Effective: Benzoyl Peroxide or Salicylic Acid? [3]

Determining the effectiveness of benzoyl peroxide versus salicylic acid hinges on understanding the nature of acne and how each ingredient targets specific aspects of its development. Benzoyl peroxide demonstrates robust efficacy against inflammatory acne typified by red, swollen pimples often referred to as papules and pustules. It’s potent antimicrobial properties directly combat the proliferation of C. acnes bacteria within the pores, curbing the inflammatory response and reducing the severity of existing acne lesions. Moreover, benzol peroxide’s keratolytic action aids in unclogging pores, preventing further bacterial proliferation and thereby promoting healing of inflammatory acne.

Salicylic acid, on the other hand, works best at treating non-inflammatory acne manifestations like blackheads and whiteheads, i.e., “comedones”.  As was mentioned above, salicylic acid penetrates deep into the pores to loosen (dissolve) the oily bonds between the dead skin cells to unclog the pores and remove the debris present therein to prevent formation of new comedones by reducing pore congestion. This exfoliating capability positions salicylic acid as a preferred option for those individuals dealing with non-inflammatory acne.

In short, for those suffering from inflammatory acne, i.e., papules and pustules (red, painful, puss-filled pimples), benzoyl peroxide would most likely represent the preferred anti-acne ingredient (provided there are no skin sensitivity/irritation issues) primarily due to its powerful C. acnes bacteria killing properties. Conversely, for those who suffer more from comedonal acne (bumps on the skin rather than inflamed, painful pimples), hormonal acne, clogged pores and/or have sensitive skin which benzoyl peroxide can exacerbate due to its inherently harsh chemical makeup, salicylic acid represents the preferred anti-acne ingredient.

Should I Use Benzoyl Peroxide or Salicylic Acid with Tretinoin?

Tretinoin (a vitamin A derivative) is a highly potent, prescription-only retinoid used to treat especially problematic acne blemishes. It works by promoting skin cell turnover by clearing dead skin cells from the skin to enable new skin cells to rise to the surface, thereby opening the pores to allow trapped bacteria and/or other irritants to be released. These types of retinoids also help to regulate (control) sebum (oil) production to help prevent future breakouts while also possessing anti-inflammatory properties for treating acne pustules.

Combining tretinoin with benzoyl peroxide or salicylic acid can yield enhanced outcomes, especially for those dealing with exceptionally troublesome acne lesions. Both benzoyl peroxide and salicylic acid target different aspects of acne formation, while tretinoin complements their effect due to its enhanced skin cell turnover properties. Benzoyl peroxide’s antimicrobial properties work synergistically with tretinoin’s exfoliating capabilities to clear acne blemishes. Salicylic acid’s ability to unclog pores by dissolving the oily bonds that hold the debris together pairs well with tretinoin’s capacity to promote the shedding of dead skin cells before they can be used to form pore-clogging debris.

That said, caution is warranted when incorporating these anti-acne ingredient combinations into an acne treatment regimen when it comes to those with sensitive skin. The potent nature of tretinoin, coupled with the potential drying and irritating effects of benzoyl peroxide and salicylic acid can lead to heightened skin sensitivity and discomfort. To mitigate these risks, a gradual introduction of the combined treatments is recommended, allowing the skin to acclimate to the regimen over time.

In addition, close monitoring of skin response is essential, with adjustments made as needed to prevent excessive dryness or irritation. Consulting with a dermatologist (who will need to prescribe the use of tretinoin) can provide personalized guidance to ensure that the combination of benzoyl peroxide, salicylic acid, and tretinoin is tailored to an individual’s skin concerns and of course, tolerances.

Do Benzoyl Peroxide and Salicylic Acid Make Acne Worse Before It Gets Better?

A phenomenon known as “purging” oftentimes associated with the use of salicylic acid can initially cause concern among individuals seeking relief from acne using this ingredient. Salicylic acid’s exfoliation properties trigger an acceleration in the shedding of dead skin cells/expulsion of debris from within the pores, which can result in a temporary worsening of acne due to underlying (not very visible) blemishes being brought to the skin surface. Consequently, an individual may experience an increase in the frequency or severity of breakouts during the initial stages of salicylic acid use which can initially cause a user to experience frustration and disappointment in its ability to effectively improve this skin condition.

That said, it is important to keep in mind that the initial purging phase is a transient phenomenon that typically subsides with continued use of salicylic acid. More particularly, as the skin adjusts to the exfoliating effects of salicylic acid, the frequency and severity of breakouts tend to diminish over time. The accelerated skin cell turnover induced by salicylic acid helps to unclog pores and prevent formation of new comedones which ultimately leads to clearer, healthier skin. Hence, for those asking themselves, “Why is salicylic acid not working on my acne?”, while the initial exacerbation of acne may be disappointing, it’s often a sign that salicylic acid is effectively addressing underlying congestion within the pores and, with a little patience, you will see the effectiveness of this anti-acne ingredient when it comes to improved skin texture and reduced acne severity.

To be fair, Benzoyl peroxide also comes with a learning curve when it comes to acne treatment. During the first 3 weeks of benzoyl peroxide usage your acne (just like with salicylic acid usage) may also seem like it’s getting worse AND your skin may become quite irritated due the inherently harsh nature of this ingredient. And, to make matters worse, certain over-the-counter (OTC) acne products may cause rare and life-threatening allergic reactions as evidenced by symptoms like the formation of hives, itching, trouble breathing, swelling of the eyes, face, lips, or tongue, tightness in the throat, or feeling faint. 

 

Can Benzoyl Peroxide and Salicylic Acid Be Used Together?

The short answer is no!

Especially when using benzoyl peroxide, one should also avoid using “other” topical medicines which can interfere with this ingredient’s mode of action, within 1 hour before or after its application. It is especially important to avoid using the following skin products on the same area as benzoyl peroxide:

• Any other topical acne or skincare product containing a peeling agent such as resorcinol, salicylic acid, or sulfur;
• Hair products that are inherently irritating like perms or hair removal (depilation) products;
• Skincare products with sun sensitizing ingredients (citrusy and/or spicey);
• Skincare products containing large amounts of alcohol (astringents, shaving creams, or after-shave lotions); and
• Skincare products that are exceptionally drying or abrasive (certain cosmetics, soaps, or skin cleansers).

As a rule of thumb, always check with your doctor prior to using any products in combination with benzoyl peroxide. And in the event your skin becomes exceptionally dry/irritated or if you start to develop symptoms indicative of an allergic reaction, seek medical attention immediately. [5]

What Is a Good Alternative to Benzoyl Peroxide and Salicylic Acid?

In the world of acne management, sulfur stands out as a compelling alternative to benzoyl peroxide and salicylic acid, offering a gentler yet effective approach to treating acne-prone skin. Well-known for its antimicrobial, anti-inflammatory, and sebum-regulating properties, sulfur serves as a versatile ingredient in skincare formulations designed to combat acne. Unlike benzoyl peroxide which can be drying and quite irritating for some individuals, sulfur tends to be better tolerated by sensitive skin types, making it an appealing option for those seeking gentler alternatives. Additionally, sulfur’s anti-inflammatory properties help to alleviate redness and swelling associated with acne, promoting a calmer, more balanced complexion.

Moreover, sulfur’s sebum-regulating capabilities make it particularly adept at addressing excess oil production, a common contributing factor to acne development. By regulating sebum levels, sulfur helps to minimize pore congestion and reduce the likelihood of acne breakouts. This dual action approach which targets both inflammation and excess sebum production positions sulfur as a comprehensive solution for acne management without the potential side effects associated with benzoyl peroxide and salicylic acid. [4]

Conclusion.

In the realm of acne treatment, knowledge and informed decision-making are of paramount importance. Understanding the mechanisms and effectiveness of skincare ingredients like benzoyl peroxide and salicylic acid empowers individuals to navigate their skincare routines with confidence. At the end of the day, the difference between benzoyl peroxide and salicylic acid comes down to the age-old question, “What’s more effective benzoyl peroxide or salicylic acid?”, i.e.  is benzoyl peroxide or salicylic acid better, the answer depends on the type of acne you’re suffering from (bumps vs pimples) and whether you have sensitive skin.

For those seeking effective, comprehensive, and gentle solutions for acne treatment and management, the Codex Labs SHAANT® COLLECTION of oil-reducing, inflammation-calming, blemish-zapping, and microbiome-friendly products is precisely the long-term acne solution your skin has been in need of. With its revolutionary patented, ShaantComplex® technology specifically designed to help those with oily, acne-prone skin effectively treat and manage this annoying skin condition, these products have been proven to help reduce oiliness, purify pores, shed dead skin cells, and reduce redness. How can we be so sure? Because we have the clinical data to prove it!

And in case your still skeptical, to help you keep track of the progress being made using your selected SHAANT® COLLECTION products, you may also want to take advantage of Codex’s newest acne-fighting tool, DERMSCORE®, an AI-powered, mobile phone operated skin analyzer. And because it’s FREE to use you literally have nothing to lose, but only valuable insight, information, and acne-free skin to gain. Doesn’t your skin deserve it?

References:

1. https://www.nhs.uk/medicines/benzoyl-peroxide/about-benzoyl-peroxide/
2. https://medlineplus.gov/druginfo/meds/a607072.html
3. https://www.goodrx.com/benzoyl-peroxide/benzoyl-peroxide-vs-salicylic-acid
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047935/
5. https://www.mayoclinic.org/drugs-supplements/benzoyl-peroxide-topical-route/precautions/drg-20062425#