Over-the-counter acne treatments can help you keep your skin clear and blemish-free. But some of these lotions and gels also could produce dangerous reactions that may, in rare circumstances, be life-threatening.
The Food and Drug Administration (FDA) recently issued a warning that says products containing the ingredients benzoyl peroxide or salicylic acid can cause rare but serious and potentially life-threatening allergic reactions or severe irritation.
The FDA warning was prompted by 131 reports of serious allergic reactions from these products, which include gels, lotions, facial washes, cleansing pads, toners and facial scrubs. The reports came from consumers and manufacturers between 1969 and January 2013.
Allergy-like reactions
The serious reactions reported to the FDA were severe allergy symptoms such as:
- Throat tightness
- Shortness of breath
- Wheezing
- Low blood pressure
- Fainting
- Collapse
People also reported isolated instances of hives, or itching on the face or body – even of parts of the body where the person did not apply the medication – and swelling of the eyes, face and lips.
About 42 percent of the people who had reactions experienced them within minutes to 24 hours after using the products. No deaths were reported, but 44 percent of the people who had severe reactions required hospitalization.
Stopping blemishes
The products’ active ingredients are either benzoyl peroxide or salicylic acid. The FDA cannot determine if the products’ active ingredients, the inactive ingredients, or both triggered the reactions.
Salicylic acid is derived from willow tree bark. When applied to the skin to treat acne, salicylic acid reduces swelling and redness and unplugs blocked skin pores to allow pimples to shrink. Salicylic acid treats other skin conditions by softening and loosening dry, scaly, or thickened skin so that it falls off or can be removed easily.
Benzoyl peroxide is an antibiotic used to remove bacteria from the skin. It also is a bleaching agent, and can be found in non-acne products such as hair dye. Unlike oral antibiotics, there is no risk of bacteria becoming resistant to benzoyl peroxide even if you use it frequently.
These two blemish-fighters also can also irritate the skin, causing side effects like redness, itching, burning, dryness, peeling and slight swelling, says dermatologist Carol Slover, MD. Dr. Slover did not have a role in the FDA warning.
The FDA warning concerns the more serious allergic reactions.
“Since all acne medications can cause irritation to the skin, consumers need to determine whether they are seeing a side effect or a serious allergic reaction,” Dr. Slover says.
Go slow
Products containing salicylic acid and benzoyl peroxide are still safe to use, Dr. Slover says. But she urges consumers to read the labels on these products.
Benzoyl peroxide comes in several concentrations, such as 2.5 percent, 5 percent and 10 percent. The higher concentrations do not necessarily work better than the formulas with lower concentrations, Dr. Slover says. But the side effects are more common with the higher percentage formulas.
Go slow when you try out a new over-the-counter acne medication, Dr. Slover says. Apply a small amount of the product to a small affected area for a few days. If you don’t experience any discomfort, then you can follow the label’s directions for normal use.
If you experience minor irritation, discontinue use of the product, Dr. Slover says. You should seek medical attention immediately if you experience any of the severe, allergic-reaction type symptoms.
