Salicylic Acid vs. Benzoyl Peroxide For Acne

Salicylic acid and benzoyl peroxide are two common acne treatments. Most over-the-counter and prescription acne medications contain one, the other, or both. Both are effective at clearing breakouts, but they do so in different ways.

The salicylic acid vs. benzoyl peroxide debate really comes down to the type of acne you have:

• Benzoyl peroxide targets acne-causing bacteria and works best on red, inflamed acne and whiteheads.
• Salicylic acid exfoliates to help shed dead cells that clog pores and is helpful for rough, bumpy breakouts with minimal redness.

This article discusses salicylic acid and benzoyl peroxide acne treatments. It explains how the acne-fighting ingredients work, the potential side effects of each, and when to choose one over the other.

How Benzoyl Peroxide Helps Clear Acne

Benzoyl peroxide is considered the quintessential topical acne treatment. It works to clear breakouts in two ways:

1. It reduces acne-causing bacteria on the skin.
2. It clears excess oil and dead skin cells from your pores.

Benzoyl peroxide is considered the most effective OTC acne treatment ingredient available. It is found in countless over-the-counter products, including cleansing bars and liquids, astringents, creams, gels, lotion, and masks. 

Benzoyl peroxide is typically used once or twice a day, and it may take four to six weeks to see the effects of this medication. 

Benzoyl peroxide is not just an OTC treatment. Prescription acne medications often combine benzoyl peroxide with an antibiotic, like Onexton (clindamycin and benzoyl peroxide), or a topical retinoid, like Epiduo (adapalene and benzoyl peroxide).

How Salicylic Acid Treats Acne

Salicylic acid works a bit differently than benzoyl peroxide. As a beta hydroxy acid, salicylic acid speeds up cell turnover rates. It exfoliates, helping your skin to shed dead cells more effectively. This, in turn, keeps them from building up within the pore.

Salicylic acid can be found in many over-the-counter products and formulas, including:

• Cream 
• Gel
• Liquid
• Lotion
• Medicate wipe or pad
• Ointment
• Patch
• Shampoo

It's also very popular as a chemical peel at the salon, skin spa, or dermatology clinic.

Which Is Best For Different Types of Breakouts

Because they work differently, benzoyl peroxide and salicylic acid may be better on some types of acne vs. others.

Benzoyl peroxide is a good choice if you experience:

• Blackheads
• Whiteheads
• Red or inflamed acne
• Back acne
  

If you have papules and pustules—basically, your typical zits and whiteheads—benzoyl peroxide is a great option. It is an effective bacteria reducer and is especially useful if your acne is red and inflamed.

Salicylic acid is typically recommended for:

• Comedonal acne (bumpy texture without many red pimples)
• Blackheads
• Clogged pores
• Hormonal acne
  

Salicylic acid's claim to fame is its ability to dissolve pore blockages and smooth out the skin.

Salicylic acid is also recommended as a first-line treatment for:

• Young tweens with the beginnings of acne breakouts
• Those with sensitive skin and/or sensitivity to benzoyl peroxide
  

Side Effects and Risks of Benzoyl Peroxide

Side effects of benzoyl peroxide are typically mild and include:

• Dry skin
• Feeling of warmth
• Flaking or peeling skin
• Itching
• Tingling
• Slight stinging

Sometimes, more serious side effects can occur. Call your healthcare provider if you experience any of the following:

• Blistering skin
• Burning sensation
• Rash
• Redness
• Swelling

Allergic reactions to benzoyl peroxide are also possible. Stop using benzoyl peroxide and seek immediate medical attention if you experience any of the following:

• Difficulty breathing
• Feeling faint
• Hives
• Itching
• Swelling of the eyes, face, lips, or tongue
• Throat tightness

Side Effects and Risks of Salicylic Acid

Topical salicylic acid can have side effects that range from mild to severe. Mild side effects that typically subside include:

• Skin irritation
• Stinging in or around the application area

More serious side effects may require medical attention. Call your healthcare provider if you experience any of the following after using topical salicylic acid:

• Confusion
• Diarrhea
• Dizziness
• Extreme tiredness or weakness
• Fast breathing
• Headache
  
• Hearing loss
• Ringing or buzzing in the ears
• Nausea
• Vomiting

Allergic reactions to salicylic acid are also possible. Stop using salicylic acid and seek immediate medical attention if you experience any of the following:

• Difficulty breathing
• Feeling faint
• Hives
• Itching
• Swelling of the eyes, face, lips, or tongue
• Throat tightness

The Importance of Spot Testing

Even a treatment that seems like the best one for you on paper may not react well with your skin.

So, before applying benzoyl peroxide or salicylic acid to several areas of your skin, conduct a spot test to make sure you're not sensitive to the treatment. This may be especially important for benzoyl peroxide, as it is more drying and irritating.

Apply a small amount of the product to one or two small areas of your skin for three days. If you do not have a reaction or discomfort, use the product as directed on the package label.

Can You Use Benzoyl Peroxide and Salicylic Acid Together?

You don’t necessarily have to choose one ingredient over the other, either. Using both benzoyl peroxide and salicylic acid together can help increase their effectiveness.

Many OTC products contain both benzoyl peroxide and salicylic acid. You could even use a cleanser containing salicylic acid, followed by a benzoyl peroxide lotion.

The possible side effects of both benzoyl peroxide and salicylic acid are similar—dryness, peeling, and irritation. Using them together can increase the chances of side effects, so scale back use if you're getting especially dry or irritated.

Just remember, whether they contain benzoyl peroxide or salicylic acid, OTC treatments work best for those with mild acne. If you’re not getting good results after using them for several weeks, it’s time to give your doctor a call for stronger prescription treatments.

A Word From Verywell

Benzoyl peroxide can stain fabric (bedding, clothing, or towels) and bleach hair. Avoid using your good towels to dry your face after washing with a benzoyl peroxide product.

When using leave-on topical treatments, allow the product to dry completely before changing your shirt or getting into bed.