Benzoyl Peroxide or Sulfur: How to Choose

There are a handful of over-the-counter ingredients that dermatologists have relied upon for decades to effectively treat acne. Benzoyl peroxide and sulfur are two that excel at managing inflammatory pimples: the deep, red, often painful breakouts that can be challenging to get rid of.

These anti-acne actives have a lot in common — so how do you decide which one is right for your particular skin? Here, we break down the difference between benzoyl peroxide and sulfur.

A woman with inflammatory acne that can be treated with benzoyl peroxide or sulfur

4 minute read

What is benzoyl peroxide?

The skin benefits of benzoyl peroxide were first discovered over 150 years ago, and in the 1920s, a chemist at Revlon began experimenting with it as an acne treatment. The organic (carbon-containing) white compound was billed as an effective sulfur alternative. Since then, many clinical studies have demonstrated the benefits of benzoyl peroxide due to several of its properties:

  • Anti-bacterial: kills acne-causing bacteria and other microbes both on the surface of the skin and within the hair follicles
  • Keratolytic: softens keratin and dissolves the desmosomes (the filaments that help bind skin cells together)
  • Anti-inflammatory: calms the body’s immune response to clogged and infected pores
  • Reduces sebum: studies suggest that the sebum excretion rate (SER) decreases in some patients after applying benzoyl peroxide

What skin conditions does benzoyl peroxide treat?

Benzoyl peroxide is an FDA regulated drug available both over-the-counter and by prescription to treat acne vulgaris. The medication is also used by physicians to treat a variety of skin conditions “off label” — aka without express permission from the FDA but with some established efficacy. Its most common uses include:

What are the side effects of benzoyl peroxide?

Numerous studies have shown that benzoyl peroxide is safe when used as directed — though some side effects are common, including:

  • Dryness
  • Erythema (redness)
  • Peeling
  • Photosensitivity
  • Bleaching (clothing and hair)

Who should use benzoyl peroxide?

Along with retinoids, benzoyl peroxide is considered a highly effective treatment for mild to moderate acne, particularly inflammatory papules, pustules, nodules and cysts. In cases of more severe acne, it’s often prescribed by dermatologists in conjunction with topical antibiotics. Three OTC products from SLMD Skincare to try:

Studies have shown that very little benzoyl peroxide is absorbed by the body when it’s applied topically, but there haven’t been a lot of studies to determine its effects on children, or pregnant women. It’s best to consult with a doctor in these cases.

Though it typically only causes mild irritation, an estimated 1 in 500 people have a benzoyl peroxide allergy. Interestingly, this sometimes overlaps with cinnamon allergy, due to the fact that the two contain similar compounds.

BP Lotion and Sulfur Lotion by SLMD Skincare

What is sulfur?

A naturally occurring, non-metallic element, sulfur (aka brimstone!) has been used for millennia to treat various skin conditions. It’s essential for many functions, and is a common building block of amino acids. Ancient civilizations around the world knew the benefits of soaking in soothing sulfur baths, said to alleviate a variety of skin ailments. Modern research has demonstrated the element’s many qualities, including:

  • Antimicrobial
  • Reduces sebum
  • Keratolytic
  • Antioxidant
  • Anti-inflammatory

What skin conditions does sulfur treat?

It’s been used for centuries, and modern research has shown that sulfur (both on its own and when combined into various compounds) has many applications for treating skin conditions, including:

  • Acne vulgaris
  • Rosacea
  • Psoriasis
  • Eczema
  • Seborrheic dermatitis (scaly, waxy patches)
  • Dandruff
  • Tinea versicolor (fungal infection)
  • Scabies (mite infestation)
  • Lice
  • Warts

What are the side effects of sulfur?

One of the reasons sulfur is so commonly used is that it is nearly universally tolerated, with very few side effects when used as directed. Rarely — and most often associated with overuse — topical sulfur can cause:

  • Irritation
  • Peeling
  • Erythema (redness)

Clear Out mask with sulfur by SLMD Skincare

Who should use sulfur?

Because it is so gentle, sulfur is an ideal choice for anyone with acne-prone and sensitive skin. The mineral is typically effective for treating cases of mild to moderate acne, including inflammatory breakouts. It’s also useful in treatment masks, as it helps smooth and control oil without overdrying. Two products from SLMD Skincare to try:

Research indicates that sulfur has a very low absorption rate when applied topically. Most experts agree that it’s safe to use if you’re pregnant or nursing, but always consult your doctor first.

It’s virtually impossible to be allergic to elemental sulfur, as it’s essential for human life. However, different compounds containing sulfur, as well as ingredients found in sulfur-based formulas, may cause irritation or allergic reactions in some people.

Dr. Lee’s last word

Two of the most potent active ingredients we have for treating acne are benzoyl peroxide and sulfur. Dermatologists have been using these for at least a hundred years to inhibit the growth of bacteria, exfoliate, and help calm red, irritated skin. Together with retinol and moisturizer, they’re the building blocks of my SLMD Skincare acne systems.

—Dr. Sandra Lee

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