In this episode of Topical Conversations, John Barbieri, MD, MBA, FAAD, examines the safety concerns surrounding benzoyl peroxide, a common ingredient in acne treatment products. He reviews 2 new research studies that investigate the risks associated with benzoyl peroxide use, providing insights into its safety for routine clinical practice. 

Concerns raised by Valisure report on benzoyl peroxide 

In March 2024, Valisure released a report indicating that benzoyl peroxide products may contain benzene, a potential carcinogen, due to thermal decomposition under high temperatures. This raised concerns about the safety of benzoyl peroxide in clinical practice. Dr John Barbieri addresses these concerns by discussing 2 new research studies that explore the risks associated with benzoyl peroxide use. 

Analysis of blood benzene levels in benzoyl peroxide users 

The first study analyzed data from the National Health and Nutrition Examination Survey (NHANES), comparing blood benzene levels in individuals using benzoyl peroxide products with those who did not. The study matched participants on various risk factors for benzene exposure and found no detectable differences in benzene levels between the 2 groups. Additionally, for those with detectable benzene, the average levels were similar in both groups. Dr Barbieri notes that these findings suggest that benzoyl peroxide use does not lead to increased benzene levels in the body, providing reassurance about its safety in routine clinical use. 

Long-term cancer risk assessment in benzoyl peroxide users 

The second study utilized data from TriNetX, examining a cohort of over 50,000 individuals. The study matched benzoyl peroxide users with nonusers and monitored them for 10 years. The research did not identify any increased risk of malignancy, including leukemia, lymphoma, or solid organ tumors, among benzoyl peroxide users. Dr Barbieri comments that these results further support the safety of benzoyl peroxide in clinical practice, indicating no heightened cancer risk from its routine use. 

Overall safety of benzoyl peroxide in clinical practice 

Dr Barbieri concludes by commenting that together, these studies provide valuable data, suggesting that the routine use of benzoyl peroxide products for acne and other skin conditions appears to be relatively safe. He suggests that, based on these findings, patients and clinicians can feel reassured about the continued use of benzoyl peroxide in their treatment regimens.