Topical bactericidal / Anti-acne (keratolytic) Pregnancy: No safety concern for teratogenicity, embryotoxicity or peri-/post-natal development from animal data with cutaneous use, and none associated in decades of widespread clinical use up to 10% w/w; should only be used by a pregnant woman if clearly needed. Breast-feeding: excretion in human milk unknown — exercise caution and do not apply to the chest.

Benzoyl Peroxide 2.5–10%

Brand names: PanOxyl (2.5%, 5%, 10% gel/wash), Brevoxyl (4% cream), Duac (benzoyl peroxide 5% + clindamycin 1% — combination)

Benzoyl peroxide is a topical agent used for mild-to-moderate acne, available alone and in fixed combinations with antibiotics or retinoids.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Thin layer applied to the affected areas

Route: Topical (cutaneous) — for external use only

Frequency: Once daily, or as directed

Adults and adolescents aged 12 years and over. Clean and dry the skin before each application. The extent of any drying or peeling may be adjusted by modifying the dosage schedule. It is recommended to initiate treatment with benzoyl peroxide 2.5% or 5% gel; if adequate results are not achieved with the 5% gel and the 5% gel is well tolerated, treatment with benzoyl peroxide 10% gel may be started. Safety and efficacy in children aged under 12 years have not been established. Source SPC is for Acnecide 10% w/w Gel.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substance or to any of the excipients

Side effects

Very common: dry skin, erythema, skin exfoliation (peeling), skin burning sensation
Common: pruritus, skin pain (pain, stinging), skin irritation (irritant contact dermatitis)
Uncommon: allergic contact dermatitis
Post-marketing: swelling of the face, allergic reactions including application site hypersensitivity and anaphylaxis (frequency not known)
May cause increased sensitivity to sunlight; may bleach or discolour hair and dyed fabrics

Interactions

No interaction studies have been performed; drugs with desquamative, irritant and drying effects should not be used concurrently with benzoyl peroxide gel
Concomitant topical acne therapy should be used with caution — cumulative irritancy may occur, especially with peeling, desquamating or abrasive agents

Clinical monograph

How it works

It releases oxygen radicals that are bactericidal against Cutibacterium acnes and also has mild keratolytic and comedolytic activity, and importantly reduces the emergence of antibiotic resistance.

Prescribing in practice

It bleaches hair, clothing, bedding and towels, so warn patients to avoid contact with coloured fabrics and to use white linen.
Local irritation, dryness and peeling are common; start at a lower strength or reduced frequency and build up to improve tolerability.
Combining with a topical or oral antibiotic helps limit antibiotic resistance compared with antibiotic monotherapy.

Monitoring

Assess response and skin tolerability clinically; no laboratory monitoring is needed.

Counselling the patient

Be aware that it can bleach towels, bedding and coloured clothing.
Expect some dryness and peeling at first, which usually eases with continued use.
Apply to the whole affected area rather than just individual spots.

Evidence & guidelines

Benzoyl peroxide is recommended in NICE guidance on acne vulgaris as a component of first-line topical treatment regimens.

Reference: BAD Acne Guidelines 2021; NICE CG184; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways