Is Benzoyl Peroxide Safe During Pregnancy or Breastfeeding?

Picking out pregnancy-safe skincare can seem complicated. I have an entire page on pregnancy beauty, dedicated to which skincare ingredients to avoid during pregnancy, breastfeeding, or IVF.

Today, we discuss benzoyl peroxide, an effective over-the-counter acne treatment. Available in various strengths (2.5%, 5%, 10%) and formulations (cleansers, lotions, gels, bars, and masks), it’s widely used to manage acne breakouts.

But many expectant moms may wonder, “Is benzoyl peroxide safe during pregnancy or breastfeeding?
The good news is that, when used correctly, benzoyl peroxide is considered pregnancy-safe and can also be used while breastfeeding.

Read on to find out how you can use it safely during these special stages of life.

Safety profile of Benzoyl Peroxide

The FDA categorizes benzoyl peroxide in Category C, which means that:

Studies in animals have revealed adverse effects on the fetus, and there are no controlled studies in women available.
These are medicines that have not been studied in pregnant humans but that do appear to cause harm to the fetus in animal studies.
Drugs in this category should be given if the potential benefits outweigh the side effects.

(For more information on pregnancy categories: FDA Pregnancy Categories: Understanding Drug Safety in Pregnancy & Nursing)

Despite its C Categorization, which might sound alarming, due to minimal systemic absorption and rapid excretion via the kidneys when applied topically, it is considered safe to use during pregnancy (AAD, NHS, NIH).

When it comes to breastfeeding, while there are no studies on its effects, since only 5% of topical BPO is absorbed systemically (and is rapidly excreted by the kidneys), it is considered safe to use while nursing.

There have also been no reports of any fetal malformation due to the use of benzoyl peroxide during pregnancy or any harmful effects on nursing children.

What’s so special about benzoyl peroxide?

• It has a multimodal action:
  • Kills acne-causing bacteria.
  • Reduces skin oiliness by reducing sebum secretion.
  • Mild exfoliative action.
• Unlike topical antibiotics, there is no drug resistance of the bacteria against it.
• Combines effectively with other anti-acne drugs like clindamycin (pregnancy safe), erythromycin (pregnancy safe), adapalene (not pregnancy safe), and tretinoin (not pregnancy safe)

How to use benzoyl peroxide safely during pregnancy & nursing?

• Always use it under the guidance of your doctor.
• Start at a lower concentration (Typically, 2.5%)
• Use a maximum of 5% concentration.
• Consider starting it in cleanser form for mild acne. Leave it on for a minute before rinsing.
• Start with once a day application, increasing it to twice a day if needed.
• Use on a limited area, like just the face.
• Do not overuse or overdose. It will not have beneficial effects, and instead, the side effects are compounded.
• Benzoyl peroxide is nursing safe- just ensure the infant does not come in contact with it during nursing or during skin-to-skin contact.

Precautions & Side Effects

• Skin dryness, peeling, flaking, and redness are common side effects. Make sure to keep skin moisturized with a pregnancy-safe moisturizer.
• Unless recommended by your doctor, avoid using it with other antiacne medications, like salicylic acid, that can potentially cause increased dryness and irritation.
• It can increase sun sensitivity, so sun protection measures like sunscreen and hats are essential.
• It can bleach clothes and hair, so just be aware that discoloration of your clothes and hair can happen.
• In relation to the recent news of benzene (a carcinogen) contamination of products containing benzoyl peroxide, here are some safety tips:
  • Store in a cool, dry place.
  • Do not use beyond the expiry date.
  • If the product smells, feels, or looks different, discard it even if it is within the expiry date.
  • Use it sparingly, as needed.

Takeaway

• Benzoyl peroxide is generally safe during pregnancy and nursing when used in concentrations up to 5%.
• Skin drying, peeling, and flaking are common side effects that can be mitigated with a pregnancy-safe moisturizer.
• It makes skin sensitive to sunrays and thus, sun protection is essential.

Trivia

Benzoyl peroxide can explode! And it can even light up without an ignition source. This danger, however, is only with the pure material. Cosmetics have only a small percentage of benzoyl peroxide and pose no such risk.