Is benzoyl peroxide safe during pregnancy or breastfeeding? Used correctly, yes, and here is how to use it safely.
Navigating pregnancy-safe skincare can be complicated, but as a medical doctor with a focus on cosmetic ingredient safety, I’ve simplified the search for you. Visit my Skincare During Pregnancy: Begin Here guide for a full index of ingredient safety reviews, pregnancy and IVF-safe recommendations, and doctor-vetted product guides.
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 is widely used to manage acne breakouts.
If you are wondering whether benzoyl peroxide is safe during pregnancy or breastfeeding, the good news is that, when used correctly, benzoyl peroxide is considered both pregnancy-safe and breastfeeding-safe.
Read on to find out how to use it safely during these special stages of life.
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The Verdict
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 and Nursing)
Despite its Category C classification, which might sound alarming, benzoyl peroxide has minimal systemic absorption and rapid excretion via the kidneys when applied topically, so 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 benzoyl peroxide 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.
Why It Works
What is so special about benzoyl peroxide?
It has a multimodal action: it kills acne-causing bacteria, reduces skin oiliness by lowering sebum secretion, and has a mild exfoliative action.
No drug resistance. Unlike topical antibiotics, bacteria do not develop resistance against it.
It combines effectively with other anti-acne drugs like clindamycin (pregnancy safe), erythromycin (pregnancy safe), adapalene (not pregnancy safe), and tretinoin (not pregnancy safe).
Learn more:
Pregnancy-Safe Acne Treatments
How To Use
How to use benzoyl peroxide safely during pregnancy and nursing
Always use it under the guidance of your doctor.
Start at a lower concentration (typically 2.5%) and use a maximum of 5%.
Consider starting in cleanser form for mild acne, leaving it on for a minute before rinsing.
Start with once-a-day application, increasing to twice a day if needed.
Use on a limited area, like just the face.
Do not overuse or overdose. It will not have added beneficial effects, and instead the side effects are compounded.
Benzoyl peroxide is nursing safe, just ensure the infant does not come into contact with it during nursing or skin-to-skin contact.
Good To Know
Precautions and side effects
Skin dryness, peeling, flaking, and redness are common side effects. Keep skin moisturized with a pregnancy-safe moisturizer.
Unless recommended by your doctor, avoid using it with other anti-acne 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 be aware that discoloration can happen.
In relation to the recent news of benzene (a carcinogen) contamination of products containing benzoyl peroxide, a few safety tips: store it in a cool, dry place; do not use it beyond the expiry date; if the product smells, feels, or looks different, discard it even if it is within the expiry date; and use it sparingly, as needed.
In Short
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 sun rays, so sun protection is essential.
Did You Know
Trivia
Benzoyl peroxide can explode, and it can even ignite without an external ignition source. This danger, however, is only with the pure material. Cosmetics contain only a small percentage of benzoyl peroxide and pose no such risk.
FAQ
Frequently asked questions
Is benzoyl peroxide safe during pregnancy?
Yes, when used correctly. Despite its FDA Category C classification, topical benzoyl peroxide has minimal systemic absorption and is rapidly excreted by the kidneys, and there have been no reports of fetal malformation due to its use during pregnancy.
Is benzoyl peroxide safe while breastfeeding?
Yes. While there are no studies on its effects, only 5% of topical benzoyl peroxide is absorbed systemically and it is rapidly excreted, so it is considered nursing safe. Just ensure the infant does not come into contact with it during nursing or skin-to-skin contact.
What strength of benzoyl peroxide should I use while pregnant?
Start at a lower concentration, typically 2.5%, and use a maximum of 5%, under the guidance of your doctor. Begin with once-a-day application on a limited area like the face, increasing to twice a day if needed, and consider a cleanser form for mild acne.
Can I combine benzoyl peroxide with other acne treatments?
It combines effectively with clindamycin and erythromycin, which are pregnancy safe, but adapalene and tretinoin are not pregnancy safe. Unless recommended by your doctor, avoid combining it with other anti-acne medications like salicylic acid, which can increase dryness and irritation.
What about the benzene contamination in benzoyl peroxide products?
Following the FDA’s findings and voluntary recalls, a few safety tips: store the product in a cool, dry place, do not use it beyond the expiry date, discard it if it smells, feels, or looks different even within the expiry date, and use it sparingly, as needed.
What are the side effects of benzoyl peroxide?
Skin dryness, peeling, flaking, and redness are common and can be mitigated with a pregnancy-safe moisturizer. It also increases sun sensitivity, so sunscreen and hats are essential, and it can bleach clothes and hair.
Have a pregnancy-safe skincare question?
If you would like clean, conscious, doctor-vetted guidance on what is safe to use during pregnancy and nursing, I would love to help.
