Benzoyl Peroxide and Salicylic Acid for Acne

Many of us have been at the drugstore perusing the shelves for over-the-counter acne treatment to either use alone or in combination with prescription treatment. Perhaps you have seen the two most common products that are widely used for acne treatment; benzoyl peroxide (BPO) or salicylic acid (SA). But what is the difference between the two of them and how can they help acne? Both have great benefits and some subtle differences. Let’s dive in and discuss them separately.

Benzoyl Peroxide

The first product we will touch on is BPO. When applied to the skin, this product creates an oxygen-rich environment in the pores which makes it difficult for bacteria, particularly the C. acnes bacteria, to survive. This toxic effect makes it antibacterial in that respect. Reducing the amount of C. acnes bacteria will result in fewer red and inflamed acne lesions over time. Another plus is that this product does not develop bacterial resistance like other topical antibiotics can, and it is FDA approved to treat acne. We often recommend it alongside prescription clindamycin to prevent resistance.

It is very easy to get your hands on BPO products. They are available as leave-on products or cleansers and at a variety of different price points. We tend to favor cleansers for trunk acne. It may be beneficial to start at a lower percentage of strength, such as 2.5-5% for facial acne and a higher strength of 5-10% for body acne. Beware that BPO products can stain and bleach fabric so it is important to make sure you do not have any residue left on you that can rub against clothing or towels.

Another factor to consider is that BPO can be drying for some patients and cause irritation. It will be important to listen to your skin and back off from them if significant dryness or irritation occurs with use.

Salicylic Acid

Salicylic Acid is another option for those who cannot tolerate BPO products.  SA is a Beta-hydroxy acid. This product works differently than BPO. SA can penetrate the oil glands of the hair follicles in the skin and dissolve skin cells, sebum (oil) and other build up that contributes to acne formation. Its exfoliant properties also help to slough off the top layer of the skin (the epidermis). This property makes SA products helpful for mild to moderate acne that is inflammatory or with blackheads and whiteheads.

SA also comes in different OTC topical formulations ranging from cleansers to leave-on products. Because it is an exfoliant, it has also been used in higher concentrations to treat acne scars (as an  in-office peeling agent), age spots, keratosis pilaris, and other skin conditions. As with BPO products, SA products can also cause dryness and irritation, especially with too-frequent use or in high concentrations.

How The Derm NP Can Help

If you need assistance with help deciding which one may be more beneficial for your acne, don’t hesitate to schedule a virtual visit with our dermatology-certified nurse practitioner to develop your customized acne plan.

We provide care for non-urgent dermatological conditions via telehealth visits, through which we strive to provide five-star care that considers your schedule. Contact us at (630) 233-9767 or at or visit our scheduling link to book your convenient consultation today.

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The Derm NP will be closed from 

8/5/2023 -8/13/2023

We will resume operations on 8/14/2023. If you have an urgent matter, you may contact us at

(630) 233-9767.