Salicylic acid and benzoyl peroxide are two of the most commonly used skincare ingredients for acne. However, despite their popularity, there’s often a lot of confusion about what they can and can’t do. In fact, a lot of people make the mistake that they’re interchangeable even rotating or “cycling them” particularly as spot treatments for active breakouts. This misuse actually leads to poor results and frustrated acne sufferers thinking that these products don’t work for them. The truth is that salicylic acid and benzoyl peroxide are highly effective treatments for acne but they work in very different ways and have different uses. However, to get the most out of them requires understanding what type of acne you have and what they can do. In this article we explore the differences between benzoyl peroxide vs salicylic acid for acne and how to use them properly.
What is Benzoyl Peroxide?
Benzoyl peroxide is an antimicrobial and anti-inflammatory ingredient used to treat acne. Its primary action is reducing Cutibacterium acnes which is a bacteria that normally lives on the skin but can overgrow and cause inflammatory acne lesions like papules, pustules and cysts. Benzoyl peroxide kills this bacteria within the follicles thereby limiting the inflammatory response that comes form its overgrowth. This action makes benzoyl peroxide particularly effective for acne that is red, inflamed or tender. Improvement in the colour and size of the acne lesions is often quick (within a few days) of using benzoyl peroxide. Even more important is that fact that benzoyl peroxide serves a similar function to antibiotics in acne but without the risk of antibiotic resistance. For this reason, it is often used either as an alternative to alongside topical or oral antibiotics to boost their effectiveness and reduce the course needed. However, despite its many benefits, benzoyl peroxide does not treat or prevent follicular (pore) blockage which is a key underlying driver of acne formation in the first place. This pore clogging is due to abnormal keratinisation and sebum (oil) production which leads to microcomedone formation (the precursor to acne).
What is Salicylic Acid?
Salicylic acid is a beta-hydroxy acid that works by increasing skin cell turnover to speed up removal of dead skin cells which in ace cause pore clogging. It dissolves in oil and so can penetrate deep into the pores to loosen the accumulation of keratin, dead cells and sebum that leads to follicle blockage. These actions make salicylic acid particularly suitable for treating early non inflammatory acne lesions such as blackheads and whiteheads. It is also useful for preventing microcomedone formation. Because salicylic acid works by gradually normalising exfoliation within the follicle, its effects tend to be slower and more subtle. It essentially modifies one of the main drivers of acne. As such its main value is overtime preventing breakouts in the first place. So vs benzoyl peroxide, salicylic acid is less useful for active inflammatory breakouts. By itself, it has limited direct activity on bacterial overgrowth.
Which is Better for Acne?
Both ingredients are widely available, easy to use and often positioned as first-line acne treatments. Whilst this is true to an extent, the reality is more complex. First of all, neither ingredient is universally “better” for acne. They work in different ways and hence their use and effectiveness depends on the type of acne you have. Benzoyl peroxide’s main benefits for acne are due to its anti-microbial and anti-inflammatory actions. As such it is generally more effective in inflammatory acne for:
- Inflamed acne lesions like papules and pustules
- Spot treatment of active and acute pimples especially where there there is redness and tenderness
- Adjunct to or maintenance after acne antibiotic treatments
- Preventative management of persistent inflammatory acne
Where benzoyl peroxide is not so useful is in modifying the underlying drivers of acne or in the management of non inflammtory acne lesions. Here salicylic acid plays a more important role and generally more effective for:
- Clearing blackheads and whiteheads
- Preventing pore clogging which leads to microcomedone formation and acne
- Improving texture and post-acne marks due to inflammatory acne
- As a maintenance treatment
Can You Use Benzoyl Peroxide & Salicylic Acid Together?
Benzoyl peroxide and salicylic acid target different aspects of acne and as such can complement each other. However, using them together requires careful consideration as both ingredients can be irritating and drying to the skin. In general, here are some of our top tips for when to use them together and how:
- Acne Type: If your only concern is blackheads and whiteheads then benzoyl peroxide isn’t useful and you’re better off with salicylic acid alone. If you have inflammatpry acne then using benzoyl peroxide will help reduce the severity of this whilst salicylic acid can help in teh long term tackle the key drover of acne forming in teh first place.
- Skin Type: If you have very dry or sensitive skin then it is best to use these treatments at different times of day or even rationalise them. For example, you can use benzoyl peroxide sparingly as a spot treatment on fresh pimples and then at a different time of day use salicylic acid all over the face.
- Pairing: Both these ingredients are incredibly effective with proper use and as part of a complete acne skincare routine. You may need to incorporate retinoids, oil controlling ingredients and even prescription medicines for full acne control and clearance.
- Protection: Acne treatments can be harsh on the skin and the disease itself can cause damage. Ensure your support your skin barrier and health by using hydrating, nourishing and sun protecting measures.
Risks & Side Effects of Benzoyl Peroxide vs Salicylic Acid
Both these ingredients are effective and with correct use don’t usually cause much in teh way of peroblems. Still, as with everything, there are some possible side effects and risks especially with improper use. For benzoyl peroxide, the most common ones include:
- Dryness and peeling
- Redness and irritation
- Increased sensitivity to other treatments
Mny of the possible side effects of salicylic acid tend to come from overuse. These include:
- Purging
- Skin barrier disruption
- Stinging or irritation
- Peeling and dryness
- Post inflammatory hyperpigmentation
- Lower tolerance for other actives
Skin type and the health of your barrier play a key role in how well you tolerate either of these ingredients or other actives. People with sensitive, eczema-prone or reactive skin as well as those already using other exfoliants are more likely to experience irritation. This is why it is important to introduce new skincare gradually at low frequency and strength initially. Always do a patch test to check for allergy. Lastly, whilst benzoyl peroxide can be used in pregnancy and during breastfeeding, salicylic acid is not suitable in these situations. Nor can people with aspirin allergy use it.
Benzoyl peroxide and salicylic acid are not competing ingredients but tools that help in different ways. One targets acute inflammation and bacterial activity whilst the other addresses the follicular blockage that drives all forms of acne. They can also be useful together as part of a comprehensive ace skincare routine. However, despite optimal use, acne can still persist due to hormonal influences, deeper inflammation or significant follicular dysfunction. These often require additional measures that may include prescription medicines or professional treatments. As always, everyone’s skin is different and your own skin will also change in response to the internal and external environment. If your acne persists or gets worse, it may be best to seek medical help in order to address the underlying causes.
At City Skin Clinic, we are immensely passionate about personalised skincare. Our virtual skin clinic offers safe and effective custom skin treatments. Where appropriate our doctors use ingredients such as Tretinoin, Hydroquinone, Azelaic acid and Tranexamic acid to treat skin conditions like acne, hyperpigmentation, melasma and skin ageing. Start your online consultation today. The journey towards great skin starts here.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical provider for any medical concerns or questions you might have.
