Benzoyl Peroxide vs. Salicylic Acid for Acne

Acne: It’s a condition we often associate with teens but that affects many adults, too. If you’re living with less-than-perfect skin, you’re not alone. Acne affects an estimated 50 million people in the U.S. 

Don’t underestimate the big problems that these little blemishes cause. Acne can impact a person’s physical and mental health.

When it comes to getting rid of pesky pimples, people often turn to the skin care aisle of their local pharmacies first. But with an overwhelming amount of over-the-counter (OTC) acne treatment options available, how can you decide what to use?

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In this article, we’ll take a close look at two of the most common OTC acne treatments: benzoyl peroxide and salicylic acid. 

What is benzoyl peroxide?

Benzoyl peroxide is an antiseptic that works by killing acne-causing bacteria on your skin. You can find it in a wide range of OTC products — creams, cleansers, gels, and more — that contain 2.5% to 10% of the active ingredient. 

Even though benzoyl peroxide is available OTC, your healthcare provider can also prescribe it. While the strengths are the same as OTC products, prescription products may help you save money, depending on your insurance coverage or if you use a GoodRx coupon for benzoyl peroxide. 

What is salicylic acid?

Salicylic acid works by exfoliating skin, removing dead cells that can build up and block your pores. The exfoliating effect can also make your skin look smoother and pores look smaller.

Salicylic acid is a natural acid that was originally made from the bark of certain trees. But, now, there’s no need to head to the forest. These days, it can be found in a variety of products, including lotions, creams, and cleansers. 

OTC salicylic-acid treatments for acne are available in strengths of 0.05% to 5%. Higher strengths exist, but those are usually used professionally in chemical peels and to remove warts.

How are benzoyl peroxide and salicylic acid used?

Both benzoyl peroxide and salicylic acid can be used to treat acne on the face and body. They come in a wide range of options, from body washes to spot treatments. Benzoyl peroxide is typically used 1 to 2 times a day, while salicylic acid is typically used 1 to 3 times a day. 

Follow the instructions on the package carefully, as the directions are unique to the type of product you’re using. In general, cleansers and washes should be applied to wet skin in place of soap, then washed off. Other products like lotions, creams, and spot treatments should be applied to clean, dry skin and left on. 

While choosing which product to use is based mainly on your preference, we’ve included tips to help in the decision-making process at the end of the article. And be sure to ask your healthcare provider or pharmacist if you have questions regarding the specific OTC acne treatment you’re using.

How effective are benzoyl peroxide and salicylic acid for treating acne?

Current studies suggest that benzoyl peroxide is effective at treating acne when compared to no treatment or a placebo (a product with no medication in it). In fact, the American Academy of Dermatology (AAD) recommends benzoyl peroxide as one of the first-choice treatments for all types of acne, from mild to severe. 

There’s less scientific data supporting the use of salicylic acid for acne. Because of this, the AAD doesn’t recommend for or against using salicylic acid. But don't dismiss salicylic acid as a valid treatment option before reading about its possible advantages when it comes to side effects, below.

What are the side effects of benzoyl peroxide and salicylic acid?

Both medications are generally well-tolerated. Benzoyl peroxide has a good safety profile for people who are 12 years of age and older. And salicylic acid is considered safe to use for most people.

Both benzoyl peroxide and salicylic acid are considered safe to use during pregnancy for short amounts of time. But if you’re pregnant, you should always speak with your healthcare provider before starting any new medication or OTC product. 

The most common side effect of both benzoyl peroxide and salicylic acid is mild to moderate skin irritation, which can include dryness, redness, or peeling. These side effects are usually most noticeable when you first start treatment but may get better over time.

Benzoyl peroxide also comes with a unique side effect: bleaching. It may leave bleached spots on fabric it comes into contact with, like clothing and pillowcases. And it can even bleach your hair. This is something to consider if you tend to sweat a lot or wear dark clothing.

Can you use benzoyl peroxide and salicylic acid together?

Some people do. In fact, some manufacturers sell kits that provide both benzoyl peroxide and salicylic acid to use at different times of the day. A common regimen involves using a salicylic-acid face or body wash and then using a benzoyl-peroxide cream as a spot treatment.

Your acne-treatment regimen may include one product or many products. Just remember that both benzoyl peroxide and salicylic acid can cause skin irritation on their own. This side effect might be worse when using them together.

Also, be aware that many acne products — both OTC and prescription-only — include a combination of ingredients. This could cause you to apply too much of one medication without realizing it. Read the labels of your products to make sure you’re not using any ingredients excessively.

It’s best to start with a single-ingredient product and ask your healthcare provider or pharmacist how and when to combine it with other products.

Helpful tips for getting started with benzoyl peroxide or salicylic acid

If you’ve never used any OTC acne medications before, there are a few things you should keep in mind:

1) More is not always better. Start with the lowest-strength option and use it once a day, unless your healthcare provider recommends otherwise. Begin by applying a small amount to a few small areas of your skin that need treatment for 3 days. If there’s no irritation, go ahead and apply it to a larger area of skin.

2) Lower-cost generics are available. Acne treatments are available as brand-name and generic versions. Generic medications can help you save money without sacrificing quality. Comparing the active ingredients on products can help you make sure you’re selecting the same medication.

3) Be kind to your skin. Avoid products that contain skin irritants, like alcohol and strong soaps. Your skin may also be more sensitive to the sun during your acne treatment. Avoid tanning booths and use sunscreen before going outside.

4) Be aware of bleaching if you’ll be using benzoyl peroxide. Tie back long hair to avoid contact, and avoid applying it directly to your eyebrows. Consider using white pillowcases and towels. If you’re only using benzoyl peroxide once a day, applying it at bedtime can help limit the amount of bleaching to your clothes.

5) Be patient. With either treatment, it may take 4 to 6 weeks or more to see a noticeable difference in your skin. If you’re still not seeing desired results in 3 to 4 months after starting an acne regimen, check in with your healthcare provider. It might be time to try a different product.

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Written by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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