Guide · Benzoyl peroxide
Benzoyl peroxide in Singapore how it works, which strength to use, and how to avoid the dryness
Benzoyl peroxide is one of the oldest and most useful acne treatments, and bacteria are not known to become resistant to it. Here is what each strength does, how to use washes and gels in Singapore's heat, and how it fits with retinoids and antibiotics.
Quick answer
- Benzoyl peroxide is an acne medicine, sold in Singapore pharmacies without a prescription, mainly as gels and lotions, that kills acne-causing bacteria and helps unblock pores. Bacteria are not known to become resistant to it, which is why acne guidelines give it a strong recommendation and pair it with antibiotics.
- Strength matters less than people think: a review of the studies found 2.5%, 5% and 10% similarly effective, while dryness and irritation rise with strength. Start low, use a thin layer or a short-contact wash, and judge it after eight to twelve weeks.
- It bleaches fabric and hair, so use white towels and pillowcases. It can be used with adapalene but should not be applied at the same time as tretinoin, and anyone using an antibiotic for acne should use benzoyl peroxide alongside it to limit resistance.
- Gels combining it with clindamycin or adapalene are prescription-only medicines. Deep, painful or scarring acne needs a doctor: Dr Sin Yong treats acne at IN Eternity Clinic, Pacific Plaza, priced at consultation; SkinRev Lab does not prescribe.
The basics
What benzoyl peroxide does to acne
Benzoyl peroxide is an oxidising agent. On the skin it breaks down and releases reactive oxygen that kills Cutibacterium acnes (C. acnes, formerly Propionibacterium acnes), the bacterium that multiplies inside blocked, oily pores and feeds inflammation. It also has a mild peeling effect that helps loosen the plugs of oil and dead skin cells behind blackheads and whiteheads.
That makes it most useful for red spots and pus-filled pimples. Its effect on blackheads and whiteheads is smaller, and a retinoid such as adapalene does more there, which is why the two are so often combined. It does not shrink oil glands or change hormones, so it controls acne rather than curing it, and spots tend to return if you stop.
The American Academy of Dermatology's 2024 acne guideline, built on a systematic review, gives benzoyl peroxide a strong recommendation, alongside topical retinoids, topical antibiotics and oral doxycycline. In Singapore, a Changi General Hospital medication leaflet describes it as helping to kill the bacteria that cause acne.
Resistance
Why benzoyl peroxide matters: antibiotic resistance
Antibiotics also reduce acne bacteria, as gels and lotions (clindamycin, erythromycin) or tablets (doxycycline, minocycline), but bacteria can become resistant to them. A systematic review in The Lancet Infectious Diseases reported that in many countries more than half of C. acnes strains are resistant to topical macrolide antibiotics, the group that includes erythromycin, which makes them less effective.
Benzoyl peroxide kills bacteria by oxidation rather than by blocking one bacterial process, and a review of the clinical evidence concluded that combination treatments containing it do not induce bacterial resistance. The Lancet review therefore recommends a retinoid with benzoyl peroxide instead of a topical antibiotic where possible, oral antibiotics only alongside a retinoid or benzoyl peroxide and ideally for no longer than three months, and always adding benzoyl peroxide when a longer antibiotic course is needed.
The AAD guideline makes the same points as good practice: limit oral antibiotic use, and combine any oral antibiotic with topical treatment such as benzoyl peroxide. If you have been given an antibiotic gel to use on its own for acne, ask your doctor whether benzoyl peroxide should be added.
Strengths
Benzoyl peroxide 2.5% vs 5% vs 10%: which strength?
Higher is not stronger in the way people expect. A review of the clinical studies found benzoyl peroxide equally effective at 2.5%, 5% and 10%, with irritation that rises with concentration. Most people do well on 2.5% or 5% on the face and keep 10% for oilier, tougher skin on the back and chest, often as a wash.
The base matters too. Creams and lotions suit drier skin; gels suit oily skin but can sting more; washes spread a thin layer over a large area and are rinsed off. Singapore pharmacies commonly stock 5% and 10% gels and lotions, and Singapore's National Drug Formulary lists 2.5%, 5% and 10% gels; for a gentler 2.5%, ask a pharmacist or your doctor.
| 2.5% | 5% | 10% | |
|---|---|---|---|
| Effect on red spots | Similar to the higher strengths in studies | Similar | Similar |
| Dryness and irritation | Least | Moderate | Most |
| Usually suits | Sensitive or dry skin, first-timers, the face | Most faces; the strength most widely listed by Singapore's polyclinics and hospitals | Oily skin, the back and chest, short-contact washes |
| Common forms | Gel or cream | Gel, cream, lotion or wash | Gel, lotion or wash |
Washes vs leave-on
Washes, gels and short-contact therapy
Leave-on gels, creams and lotions stay on the skin, so they deliver the most benzoyl peroxide to each pore and suit the face. Washes are rinsed off, which makes them gentler, quicker to use on the back and chest, and less likely to bleach clothing. But a wash only works if it stays on long enough.
That is the idea behind short-contact therapy: apply the wash or cream, leave it on for about two minutes, then rinse. In a two-week study on the back, a 9.8% foam left on for two minutes once a day reduced C. acnes about as much as a 5.3% leave-on foam, while an earlier study found that an 8% wash rinsed off after 20 seconds did not reduce bacterial counts. The study measured bacteria rather than spots, but it supports giving a wash a minute or two.
Short contact also suits skin that stings with leave-on products: lather on, count to 120, rinse, then moisturise.
- Face, mild spots: 2.5% or 5% gel or cream, a thin layer once a day.
- Face, sensitive or dry: 2.5% cream, or a wash used as short contact.
- Back, chest and shoulders: a 5% to 10% wash, left on for about two minutes in the shower.
- A single red pimple: a thin dab of 2.5% to 5%, once or twice a day.
Getting started
How to start benzoyl peroxide without the dryness
Dryness is the most common reason people give up. Singapore's humidity helps, but air-conditioned offices dry skin out, so adjust your moisturiser to how your skin feels rather than to the weather outside.
In Asian skin, irritation can leave dark marks (post-inflammatory hyperpigmentation, PIH) that outlast the spots. Using benzoyl peroxide gently and steadily is better than using a high strength hard and then stopping.
- Start with 2.5% or 5% once a day, or every other day if your skin is sensitive.
- Apply a thin layer to clean, dry skin over the whole area where you break out, not only on the spots you can see.
- Keep it away from the eyes, lips and the creases beside the nose.
- Follow with a light, non-comedogenic moisturiser, and use sunscreen in the day.
- Expect some dryness, peeling and mild stinging in the first weeks; cut back to alternate days rather than stopping.
- Stop and see a doctor if you get swelling, blisters, intense itching or a rash spreading beyond where you applied it; a true allergy is uncommon but possible.
- Give it eight to twelve weeks before judging; acne treatments work slowly.
Bleaching
Bleached towels, pillowcases and hair: how to avoid it
Benzoyl peroxide bleaches dyes. Changi General Hospital's leaflet advises avoiding contact with hair and coloured clothing, and pale patches on towels and pillowcases are a common surprise. It is not a skin-lightening treatment, but it can lighten hair, eyebrows or a fringe it touches.
Washes cause less trouble than leave-on products, but they still mark towels if they are not rinsed off well.
- Use white towels, pillowcases and face cloths while you use it.
- Let a leave-on product dry fully before you dress or lie down.
- Wash your hands after applying; it bleaches whatever you touch next.
- Keep it off the hairline and eyebrows, and tie long hair back at night.
- Rinse a body wash off thoroughly, and wear an old white T-shirt to bed if you treat your back or chest.
Combining
Combining benzoyl peroxide with adapalene, tretinoin and antibiotics
Combining treatments that work in different ways is one of the AAD guideline's good-practice points. Adapalene and benzoyl peroxide can be used together, and fixed-dose gels combining them are registered in Singapore as prescription-only medicines; two separate products also work.
Tretinoin is different: benzoyl peroxide can break down some tretinoin formulations, and the Changi General Hospital leaflet says not to apply the two at the same time because it reduces tretinoin's effect. Follow your doctor's timing.
If an antibiotic is part of your plan, benzoyl peroxide should be too. An antibiotic used alone lets resistant bacteria survive and spread; adding benzoyl peroxide keeps killing them, whatever their resistance.
| Partner | Combine? | How |
|---|---|---|
| Adapalene | Yes, a well-studied pairing | Together at night, or one in the morning and one at night; ready-mixed gels are prescription-only in Singapore |
| Tretinoin | Yes, but not at the same time | Often benzoyl peroxide in the morning and tretinoin at night, as your doctor directs |
| Retinol | Usually | At a different time of day; watch for dryness |
| Clindamycin or erythromycin gel | Yes, and it should be | An antibiotic gel should not be used on its own |
| Doxycycline or minocycline tablets | Yes, and it should be | A limited antibiotic course, with benzoyl peroxide and usually a retinoid |
| Azelaic acid | Yes | Often at a different time of day; also helps dark marks |
| Salicylic acid, glycolic acid, scrubs | With care | Stacking drying products raises irritation |
In Singapore
Can you buy benzoyl peroxide in Singapore pharmacies?
Yes. Plain benzoyl peroxide gels and lotions are sold over the counter at Singapore pharmacies without a prescription, commonly at 5% and 10%. The National Drug Formulary lists 2.5%, 5% and 10% gels on Singapore's Standard Drug List, and the 5% gel is the strength most widely listed by public polyclinics, the National Skin Centre and several hospitals.
Combination products are different. Gels that combine benzoyl peroxide with adapalene are prescription-only medicines. Gels combining it with clindamycin are also classed as prescription-only, although a pharmacist may supply topical clindamycin of up to 1% for acne to people aged 12 and over, in packs of up to 30 g.
Buy from a registered pharmacy, check the expiry date and store it as the pack directs. In March 2025 the US Food and Drug Administration reported that it had tested 95 benzoyl peroxide acne products for benzene and found elevated levels in six, which were voluntarily recalled; it judged the cancer risk to users very low. It advised checking products and throwing away any past their expiry date.
See a doctor
When benzoyl peroxide is not enough
Benzoyl peroxide suits mild to moderate acne, on its own or as part of a routine. See a GP or dermatologist if you notice any of the following.
A doctor can add a prescription retinoid, a limited course of an oral antibiotic, hormonal treatment for suitable women, or isotretinoin for severe or scarring acne, and can check for look-alikes that benzoyl peroxide will not help. If you are pregnant or planning a pregnancy, ask your doctor before starting any acne treatment.
- Deep, painful lumps or cysts, even a few.
- New dents, raised scars or dark marks where spots have been.
- No clear improvement after about three months of steady use.
- Itchy, same-sized bumps on the forehead, chest or back, which may be fungal acne.
- A rash around the mouth or nose, especially after using steroid creams.
- Acne that began suddenly in adulthood with irregular periods or extra hair growth.
- Swelling, blistering or a spreading itchy rash after applying it.
Where to go
Acne care in our network
Prescription acne treatment is medical. At IN Eternity Clinic, 9 Scotts Road, #12-01 Pacific Plaza, beside Orchard MRT, Dr Sin Yong examines the type and severity of the acne, rules out look-alike conditions and plans prescription creams or gels, oral medication or hormonal treatment where suitable, reviewing the plan at follow-up visits. Treatment is priced at consultation by the clinic; WhatsApp +65 8815 3008.
SkinRev Lab, at #B1-28 CityLink Mall, linked underground to City Hall and Esplanade MRT, does not prescribe or inject. HydraFacial Syndeo (S$288 to S$438 before GST; first-timer rate at the counter) lifts out blackheads and congestion with suction rather than squeezing, and SKINLDM (S$288 with a basic facial, first visit S$68, before GST) is a calming ultrasound facial for skin that feels hot or sore from breakouts or strong acne products. Tell the team at booking which acne products you use.
Sources
References & sources
- Reynolds RV, Yeung H, Cheng CE, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024;90(5):1006.e1-1006.e30.
- Sagransky M, Yentzer BA, Feldman SR. Benzoyl peroxide: a review of its current use in the treatment of acne vulgaris. Expert Opin Pharmacother. 2009;10(15):2555-2562.
- Walsh TR, Efthimiou J, Dréno B. Systematic review of antibiotic resistance in acne: an increasing topical and oral threat. Lancet Infect Dis. 2016;16(3):e23-e33.
- Leyden JJ, Del Rosso JQ. The effect of benzoyl peroxide 9.8% emollient foam on reduction of Propionibacterium acnes on the back using a short contact therapy approach. J Drugs Dermatol. 2012;11(7):830-833.
- Changi General Hospital (SingHealth). Topical acne preparations: medication information leaflet. Updated May 2026.
- National Drug Formulary (Government of Singapore). Benzoyl peroxide: active ingredient monograph [M01537].
- US Food and Drug Administration. Limited number of voluntary recalls initiated after FDA testing of acne products for benzene; findings show a small number of products with elevated levels of benzene contamination. 11 March 2025.
Common questions
Your questions,
answered
What does benzoyl peroxide do for acne?
It kills the acne bacterium C. acnes and helps loosen blocked pores. It is most useful for red and pus-filled pimples, and pairs well with a retinoid such as adapalene for blackheads and whiteheads. Bacteria are not known to become resistant to it.
Which is better: benzoyl peroxide 2.5%, 5% or 10%?
For most people, a lower strength. Studies find 2.5%, 5% and 10% similarly effective, while dryness and irritation rise with strength. Start with 2.5% or 5% on the face; 10% is mostly used as a wash on the back and chest.
Can I buy benzoyl peroxide over the counter in Singapore?
Yes. Plain benzoyl peroxide gels and lotions, commonly 5% or 10%, are sold in Singapore pharmacies without a prescription. Gels combining it with adapalene or clindamycin are prescription-only medicines, though a pharmacist may supply some clindamycin products for acne under set conditions.
Can I use benzoyl peroxide with adapalene, retinol or tretinoin?
With adapalene, yes; the two can be applied together. With retinol, usually, at a different time of day. With tretinoin, not at the same time, because benzoyl peroxide can break down some tretinoin formulations; a common approach is benzoyl peroxide in the morning and tretinoin at night, as your doctor directs.
Does benzoyl peroxide bleach clothes and hair?
Yes. It bleaches towels, pillowcases, clothing and hair it touches. Use white towels and pillowcases, let it dry before dressing, wash your hands after applying, and keep it off the hairline and eyebrows.
How long does benzoyl peroxide take to work?
Red spots may start to settle within a few weeks, but give any acne treatment eight to twelve weeks of steady use before judging it. If there is little change after about three months, see a doctor.
Should benzoyl peroxide be used with antibiotics?
Yes. Acne guidance advises against using an antibiotic on its own, and recommends combining oral antibiotics with benzoyl peroxide or other topical treatment, ideally for no longer than about three months, because benzoyl peroxide limits antibiotic resistance.
Is benzoyl peroxide safe during pregnancy?
Ask your doctor or obstetrician before using any acne treatment in pregnancy. Topical benzoyl peroxide and azelaic acid are often among the options discussed, while retinoids are avoided.
Does benzoyl peroxide contain benzene?
Some products have been found to. In 2025 the US FDA reported testing 95 benzoyl peroxide acne products and finding elevated benzene in six, which were voluntarily recalled, and judged the cancer risk to users very low. Buy from a registered pharmacy, store it as directed and discard expired products.