From the Guidelines
Benzoyl peroxide is generally considered safe to use during pregnancy, as evidenced by the 2024 guidelines of care for the management of acne vulgaris published in the Journal of the American Academy of Dermatology 1. When using benzoyl peroxide during pregnancy, it's essential to consider the following:
- The absorption through the skin is minimal, which means very little reaches the fetus.
- Topical benzoyl peroxide products, typically available in concentrations of 2.5%, 5%, or 10%, can be used for acne treatment while pregnant.
- To minimize potential side effects, it's best to use benzoyl peroxide on limited areas rather than all over the body, and at the lowest effective concentration to manage acne.
- Common side effects include dryness, redness, and irritation of the skin, which can be managed by using a gentle moisturizer.
- If severe irritation occurs, consider reducing the frequency of application or switching to a lower concentration. Some key points to note from the guidelines include:
- Benzoyl peroxide is an over-the-counter topical antimicrobial agent that releases free oxygen radicals and is mildly comedolytic.
- The guidelines recommend benzoyl peroxide for acne treatment based on moderate certainty evidence from 8 studies 1.
- Lower benzoyl peroxide concentrations and water-based and wash-off formulations may be better tolerated, reducing the risk of burning sensation, stinging, dryness, erythema, pain, peeling, irritation, fabric staining and bleaching, and uncommon contact allergy. It's crucial to inform your healthcare provider about any skincare products you're using during pregnancy, as individual circumstances may vary, and they can provide personalized advice for your situation.
From the Research
Safety of Benzoyl Peroxide During Pregnancy
- Benzoyl peroxide is recommended as a first-line treatment for acne vulgaris in pregnant women 2, 3.
- It can be used as a topical medication, either alone or in combination with other treatments such as antibiotics 2, 3, 4.
- The combination of benzoyl peroxide with topical erythromycin or clindamycin is considered safe and effective for inflammatory acne 3.
- Benzoyl peroxide has antibacterial and anti-inflammatory effects, making it a useful treatment for acne 4.
Comparison with Other Treatments
- Other topical treatments, such as azelaic acid, salicylic acid, and dapsone, are also considered safe for use during pregnancy 2, 5.
- Oral antibiotics, such as erythromycin and cephalexin, may be used for moderate to severe acne, but should be used with caution and only when necessary 3.
- Oral retinoids are contraindicated during pregnancy due to their teratogenic effects 3.
Considerations for Use
- The risk-to-benefit ratio, efficacy, acceptability, and costs should be considered when choosing a treatment for acne during pregnancy 3.
- Topical treatments, including benzoyl peroxide, are generally considered safe and effective for use during pregnancy, but should be used under the guidance of a healthcare provider 2, 3, 5.