Benzoyl peroxide: a review of its current use in the treatment of acne vulgaris

Expert Opin Pharmacother. 2009 Oct;10(15):2555-62. doi: 10.1517/14656560903277228.


Background: Owing to the use of topical and systemic antibiotics for acne vulgaris, the incidence of antibiotic-resistant Propionibacterium acnes is increasing worldwide. Topical benzoyl peroxide (BPO) is an alternative to antibiotics in the treatment of acne vulgaris.

Objective: This review describes and evaluates recent clinical literature regarding the efficacy and tolerability of BPO.

Methods: A PubMed literature search was conducted using the keywords benzoyl peroxide, acne, and combination therapy.

Results: BPO is equally effective at concentrations of 2.5, 5.0 and 10%. However, a concentration-dependent irritant dermatitis can occur with higher concentrations. The efficacy of BPO can be enhanced when used in combination with topical retinoids, antibiotics and tertiary amines. BPO-containing combinations do not induce bacterial resistance and are important first-line treatments for mild to moderate acne vulgaris.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Acne Vulgaris / microbiology
  • Administration, Cutaneous
  • Anti-Bacterial Agents / therapeutic use
  • Benzoyl Peroxide / administration & dosage
  • Benzoyl Peroxide / adverse effects
  • Benzoyl Peroxide / therapeutic use*
  • Clinical Trials as Topic
  • Dermatologic Agents / administration & dosage
  • Dermatologic Agents / adverse effects
  • Dermatologic Agents / therapeutic use*
  • Dose-Response Relationship, Drug
  • Drug Resistance, Bacterial
  • Drug Therapy, Combination
  • Humans
  • Propionibacterium acnes / drug effects


  • Anti-Bacterial Agents
  • Dermatologic Agents
  • Benzoyl Peroxide