This is a different before and after benzoyl peroxide picture than you’re expecting.
There are no wow-ee before and after photos of severe acne vs. clear skin.
(ok, you got me, maybe there’s one)
However instead what you’re about to read is even more important – it’s the secret sauce of how your skin works before and after benzoyl peroxide.
How benzoyl peroxide can help you get rid of acne.
And why I never recommend my Acne Warriors use it.
This is controversial.
And I’m inviting you to read this entire article and then make up your own opinion.
Take these facts, munch them over, then make your decision. I know it’s an important one and I want you to have all the facts plus a bit extra.
After all, your skin’s a vital organ eh. You wouldn’t let just anyone operate on your heart, so it’s only right we audition any new skincare product for your skin too.
We have the stage ready. You’re sat by my side as a judge. Simon Cowell pants are not mandatory 😉
Let’s get going shall we?…
You Will Be Offered Benzoyl Peroxide
Fact. My friend if right now you walk into your doctor’s office with acne you’re incredibly likely to be walking away with a prescription for benzoyl peroxide. It might be called PanOxyl, Acnecide, Desquame-X or Benzagel.
Psst; you tell by looking for the ‘active ingredient’ listing. It’ll usually be on the front label and you’re going to see something like 5% w/w benzoyl peroxide.
And this is because of 2 facts;
- The American Academy of Dermatology (in sync with many other health boards) recommend benzoyl peroxide as a first-line treatment for acne
- The bacteria which are causing you acne are building strong resistance to other front line acne treatments like antibiotics
Benzoyl peroxide has made itself ultra appealing to doctors because it has not yet been shown to induce bacterial resistance.
This is huge as in 2000 a study showed 55.5% of acne patients had strains of acne bacteria which were resistant to one or more antibiotics.
And if you think that’s huge, wait for this;
That figure escalated 21% from 1991.
9 years skyrocketed the number of antibiotic-resistant cases from 34.5% to 55.5%
As I’m writing this here in 2020, if we follow the same maths (which let me be clear is completely hypothetical), it would mean close to 100% resistance to ‘common antibiotics’.
You can see why doctors are in love with the before and after benzoyl peroxide (BP) results eh.
Now here’s what I think you should know before deciding whether to use BP.
Your Skin Before and After Benzoyl Peroxide
The aspirational snaps of before and after benzoyl peroxide treatments look awesome eh. If you haven’t clocked one yet, take a gander at this before and after benzoyl peroxide snap on Reddit.
Source; Reddit, “[Selfie/B&A] everyone say thank you miss benzoyl peroxide!”, June 2019.
Using benzoyl peroxide for acne works in a 3-pronged attack;
- Kills off acne bacteria – in fact, BP is a ‘potent bactericide’ – aka bacteria killer, it’s like a Dalek shouting exterminate – stay tuned for some pretty impressive stats on this
- Is anti-inflammatory – kind of a shocking statement as it’s known BP can cause your skin to get all red and irritated aka to inflame – more about this soon
- Works as a keratolytic aka helps break down skin cell bonds so your pores don’t get clogged and blocked up with skin
At face value, all of these skills look like awesomesauce. Simon Cowell is happy. Can get the job done, the question is does benzoyl peroxide have the X factor?
What I’m about to share might shock you. I think it’s important you’re aware.
1) Benzoyl Peroxide Kills Off Acne Bacteria
Spoiler alert. What sounds fantastic on the surface may not be so fantastic as we pull out the digger.
Here’s the deal, benzoyl peroxide gel, cream and face wash products have more in common with Daleks than you’d ever believe.
Exterminate. Exterminate. Exterminate.
10 year old me is right now quaking in the corner.
Studies tell us benzoyl peroxide works against acne because it’s a ‘potent bactericide’ – a skill it has because it’s a potent oxidant (remember, antioxidants help prevent skin ageing, you can imagine what oxidants do eh).
BPO combination treatment reduced the total number of P. acnes by 99% after 1 week, compared with 30 – 62% by clindamycin monotherapy.Expert Opin Pharmacother. 2009 Oct;10(15):2555-62
Quick human speak translation.
BPO = benzoyl peroxide and in this study they looked at how quickly acne bacteria ‘got knocked off’ by a well-known antibiotic used alone and then with that same antibiotic plus benzoyl peroxide.
Keep in mind this study result is just after 1 week. Crazy quick.
Alone antibiotics only killed off between 30-62%. With BP it was almost 100% in just 1 week.
Exterminate. Exterminate. Exterminate.
Here’s the dealio. When you use a benzoyl peroxide gel or cream it’s not just killing off acne bacteria;
“BPO was toxic to the bacteria P. acnes, Propionibacterium capitis, Propionibacterium avidum, Propionibacterium granulosum, Staphylococcus epidermis and Staphylococcus hominis.”Expert Opin Pharmacother. 2009 Oct;10(15):2555-62
It’s very normal for healthy skin to have small to medium (and even large) amounts of all of these types of bacteria.
In fact, having lots of small amounts of different bacteria living on your skin aka having a diverse microflora is a sign of healthy, happy skin.
Skin which resists UV stress, stays hydrated and ages well.
Extra fact, acne bacteria, in the right amounts can be super protective of your long term skin health. They even help to keep skin hydrated and happy.
Your skin before and after benzoyl peroxide is a very different picture
Imagine your skin like a rainforest and the bacteria which are right now living on it like anteaters, orangutans, sloths, leopards, antelopes and toucans.
When this rain forest is at its most lush – it has the perfect balance of animals. The food chain is balanced. The anteaters keep the ant populations in check and the leopards keep the antelope populations in check. Everyone’s working together… even though they don’t know it.
Then one day, the ant-eaters fall out of love with each other and they die out.
The ants go crazy, they breed and breed and breed and they start to eat and infect all of the rainforest plants.
Somethings going wrong and this rainforest is no longer lush.
The rainforest owner (you) decides to step in.
(if this was your skin – right now is when you’re seeing acne)
And you decide it’s time to get the diggers in – your rainforest needs clearing out.
With your diggers come wrecking balls and tree fellers and harvesters.
Before you know it – there’s no rainforest left.
Your rain forest is now in a state of deforestation.
Neither anteaters, orangutans, sloths, leopards, antelopes or toucans can live here.
Your forest looks clear. Your skin looks clear.
It is. There’s nothing living here anymore.
Do you see how this is not helpful for your skin’s long term health? And even for keeping your skin clear of acne long term? Just last week I was speaking to one of SkinCoachees in the online Acne Clinic – she used benzoyl peroxide gel for 8 months and had cleared her acne a year ago. It worked for her.
So why did she come to me for help?
Because a year later – her acne’s starting to come back. She’s starting to see those warning signs of her lush rainforest being overtaken again.
Studies show benzoyl peroxide works. However, follow-up studies which monitor progress 1 year + after treatment are few and far between. In fact, I’ve never seen one.
Using benzoyl peroxide for acne does not get to the trigger cause of your acne. If you don’t fix the trigger, your acne is highly likely to come back.
2) Benzoyl Peroxide is Anti-Inflammatory
Side benefit – benzoyl peroxide can be anti-inflammatory. Which is crazy to read because it’s well known that benzoyl peroxide can cause your skin to get red and angry. Classic signs of inflammation.
The dealiO is this.
Benzoyl peroxide can exterminate the cells which live in your skin and cause inflammation. Hence, anti-inflammatory.
“The released reactive oxygen species kill P. acnes but may also induce injury to the surrounding host cells… BPO inhibits… human polymorphonuclear leukocytes (PMNL) in a dose-dependent manner. This study indicated that the inhibition is due to BPO-induced cytotoxicity of PMNLs. Through this toxic effect on neutrophils in pilosebaceous follicles, BPO prevents the release of inflammation-enhancing signals.”Expert Opin Pharmacother. 2009 Oct;10(15):2555-62
Don’t worry if all this sounds a bit technical. All you need to know is your skin has its own immune system. And what you’re seeing as acne is your skin’s immune function identifying an intruder and reacting to it.
Your skin before and after benzoyl peroxide looks very different. Before it has a healthy immune response. After, it likely doesn’t. Big red inflamed cystic acne bumps have cleared up. The cost you pay is your skin’s immune function.
If you’re ready to try a different way, I strongly recommend you start looking at following an effective acne diet. Food is your body’s fuel my friend, it’s often the #1 trigger of acne symptoms. Get a head start with my free 1-page acne diet cheatsheet, just click here to download it now.
3) Benzoyl Peroxide Is Keratolytic
Which simply means it breaks down skin cell bonds. Super helpful because as you have acne, your pores have thickened skin in them – a huge risk factor for blocked pores. This is called hyperkeratosis. How fancy-sounding eh.
This benefit is like the side shoot of a 100-year-old oak tree. It’s smaller 😉
Potent antibacterial benefits are ‘the trunk’ of benzoyl peroxide treatments.
Weaker keratolytic benefits are a new shoot, not even yet a branch.
However, this side shoot is a key reason why during benzoyl peroxide treatment your skin’s likely to get red, hot and scaley. It’s also why with long term use, as your skin barrier gets leaky, you’re likely to get stuck in an oily-dry-oily-dry skin cycle.
I see this incredibly frequently in The Acne Clinic.
Your skin before and after benzoyl peroxide. Before it’s super oily, after it’s dry-oily-dry-oily.
My friend, now’s time to remove your Simon Cowell pants (did you choose to wear them? ;)) – benzoyl peroxide is now finished auditioning for your skin. What do you think? Worth it? Not worth it? Tell me your decision in the comments below. And please do use that green sharing button below to email this blog on to a friend in need, you are a friend indeed.
Cheryl Woodman is a scientist & award winning skincare formulator who’s more friend next door than bow tie wearing professor. As creator of Honesty For Your Skin her aim is to help you care for your skin in the best ways possible. She’s founder of the natural & fragrance free skincare brand Honesty while also hosting 1 to 1 skincare coaching to help you get your best skin yet. Find out more here.