Updates on Benzoyl Peroxide Use for Acne, with James Del Rosso, DO

After the quality assurance organization Valisure reported concerning levels of the carcinogen benzene within acne treatment products using benzoyl peroxide (BPO), many have been wondering about recommendations for acne products.¹

In a new interview with HCPLive, James Q. Del Rosso, DO, research director of JDR Dermatology Research in Las Vegas and the president of the American Acne and Rosacea Society (ARS), highlighted updates related to acne and discussed the report and its impact. His interview followed a presentation on updates at Maui Derm NP+PA Fall 2024.

“One of the things that I do is give an update on what's going on with the American Acne and Rosacea Society,” Del Rosso said. “Quite frankly, the big issue that people keep wondering about was front page news, and now it seems like it's buried on page 56 somewhere in smaller print. It is the benzoyl peroxide benzene story.”

Del Rosso noted that the announcement by Valisure had been followed by a decision to file their 8th US Food and Drug Administration (FDA) Citizen Petition. He added that Valisure’s petition has not yet received a formal response.

“This was back in the beginning of March, and we still have not gotten any formal answer back,” he explained. “There have been some general recommendations but there are still some questions about it. There have been some periodic database evaluations of cancer risk and people over time that have been treated with benzoyl peroxide or issues related to benzene.”

Del Rosso noted that benzene is not something one should be exposed to in great amounts, although he highlighted that most are exposed to it every day.

“It's in food, it's in the atmosphere, it's in cigarette smoke, it's in gas,” Del Rosso said. “If you walk through a gas station, even if you have an electric car, you're exposed to benzene…We certainly don't want to be exposed to more of it. But what this (report) actually means is still a question. Right now, the FDA designation of benzoyl peroxide being generally regarded as safe and effective, which it was before this petition was submitted, still stands.”

However, Del Rosso did add that general recommendations related to BPO products are posted on the ARS website.

“One thing that's very important is that any product that you get, keep it at minimum room temperature or in the refrigerator,” he explained. “We believe that that's going to make it less likely that there's going to be any degradation to benzene, if anything is actually going to happen. And look at the expiration date. The prescription products and the over the counter products have expiration dates. Respect them, and if they are not anything specific, then I would not keep a product for more than three months.”

Del Rosso noted that the recommendations also suggest that if a BPO product is left in a car for 3 or 4 days and exposed to high heat, this is also a problem.

“But it's really up to the FDA to look at this and give us guidance, and they've not,” Del Rosso said. “...So we're still waiting for that. The manufacturers obviously are looking at it themselves, but nothing's changed, and benzoyl peroxide is still being used and still being prescribed.”

To find out more about the topics covered by Del Rosso, view the full interview segment.

The quotes included in this summary were edited for clarity.

References

1. ^{Valisure Detects Benzene in Benzoyl Peroxide. Valisure. March 6, 2024. https://www.valisure.com/valisure-newsroom/valisure-detects-benzene-in-benzoyl-peroxide. Date accessed: September 20, 2024.}