Skin Care and Health Risks: A tale about separating facts from alarmism

Today, I want to start with a brief anecdote from my daily life. Like many of you, dear readers, I also struggle with adult acne. During my teenage years, I suffered from severe acne, which I treated with isotretinoin (commonly known as Accutane) at two different points in my life. After years of trial and error, I finally achieved an effective balance in my skincare routine, which includes using an over the counter (OTC) pharmaceutical product: benzoyl peroxide gel-cream twice a week overnight.

Recently, I was discussing an article with a friend — who is also a scientist — about concerns regarding benzoyl peroxide-based acne products potentially decomposing into benzene within their packaging. The article suggested that this might lead to an increased health risk due to continuous exposure since benzene is notably harmful [1]. Her immediate reaction, while smoking a vape, was: “So, you stopped using it, right?” I laughed and replied: “No, I did not. Are you going to stop vaping?”

This exchange, though ironic, got me thinking about the alarming headlines we often see in the media, especially those related to skin care (either to cosmetic or OTC pharmaceutical products) and the ever-present question: “Is what I’m putting on my face harmful?” It is a complex topic that deserves careful thought.

The Media Influence and Conflicts of Interest

Understandably, people seek straightforward answers when is comes to their personal health. However, what is often missing from the conversation is context. Scientific studies are frequently cited without consideration for their methodological rigor, potential conflicts of interest and actual meaning.

Here is where caution is essential regarding the influence of social media and influencers. Quoting a scientific study or having academic credentials does not guarantee unbiased opinions. Before making decisions based on someone’s statements, ask yourself: “Who benefits from this information? Why is it being shared?” In many cases, financial interests may be at play, and these interests do not always prioritize your well-being.

How to Read Scientific Studies (and Avoid Getting Lost)

If you are in the habit of reading scientific papers, do you check the paragraph that discloses conflicts of interest? Have you researched whether the authors are affiliated with organizations that could benefit from the findings? More importantly, do you base your opinion on a single study, or do you consult multiple sources to gain a comprehensive perspective? Reading between the lines is just as crucial as interpreting the literal meaning of the text.

For instance, returning to my experience with benzoyl peroxide: when I first read that it could decompose into benzene in one article, my initial reaction could have been panic. But I sought additional context. Interestingly, further studies revealed that the use of benzoyl peroxide to treat acne is not significantly associated with an increased risk of cancer [2] [3].

Furthermore, regulatory agencies, such as the European Commission, have not issued any official statements regarding the matter following the release of these new findings. As of now, the ingredient is still considered safe for use within the prescribed limits and conditions established by these authorities.

I also considered my personal experience: I have been using the product for over a decade, adhering to storage guidelines and respecting expiration dates. My health check-ups have been normal, so why panic now?

To be very clear, I am not suggesting we dismiss the information about benzene formation in benzoyl peroxide products. The findings of Kucera et al. (2024) are undoubtedly important and relevant, highlighting the need for further studies to better understand the issue. Such research could potentially lead to restrictions on the substance’s use or reformulations to prevent benzene formation in the future. However, as a regular consumer in this situation, I want to emphasize that there is no need to panic and to start demonizing the product, because current evidence shows no statistically significant association between the use of benzoyl peroxide for acne treatment and the development of malignancies.

The Context Factor: Living Is a Risk

If we analyze risks in isolation, life itself becomes a hazardous endeavor. We are constantly exposed to UVB radiation, air pollution, and heavy metals — and all of these can, to some extent, increase cancer risk.

So, when asking yourself, “Is what I’m putting on my face harmful?”, you need first to address it to a particular product and do the proper research. But for the most, a generic and honest answer is: it depends. If the product complies with regulatory standards and you do not have specific allergies or predispositions, the risks are minimal. However, adverse events are always possible because the interactions between your body, the external environment, and chemical products are incredibly complex.

The Importance of Critical Thinking

The goal of this text and it's example is to encourage a balanced approach. Do not panic at the first article or news story claiming that a component in a product you use is harmful. Trust the continuous monitoring of regulatory authorities, but maintain your critical thinking.

Finally, examine your own habits. It does not make sense to demonize a skin care product that might increase cancer risk while smoking or skipping sunscreen when exposed to the sun, right? Critical thinking begins with being honest with yourself.

Cosmetics and OTC pharmaceutical skin care products are more likely to be safe when used consciously and based on well-founded information. Strive for balance, and remember: it is not about fearing the world around us but about understanding it and making informed decisions.

References:

[1] Kucera, K., Zenzola, N., Hudspeth, A., Dubnicka, M., Hinz, W., Bunick, C. G., Dabestani, A., & Light, D. Y. (2024). Benzoyl Peroxide Drug Products Form Benzene. Environmental health perspectives, 132(3), 37702. https://doi.org/10.1289/EHP13984

[2] Garate, D., Thang, C. J., Lai, J., Golovko, G., Wilkerson, M. G., & Barbieri, J. S. (2024). Benzoyl peroxide for acne treatment is not associated with an increased risk of malignancy: A retrospective cohort study. Journal of the American Academy of Dermatology, 91(5), 966–968. https://doi.org/10.1016/j.jaad.2024.07.011

[3] Veenstra, J., & Ozog, D. (2024). Benzoyl peroxide use in acne therapy: Evaluating the association with acute myeloid leukemia risk. Journal of the American Academy of Dermatology, 91(3), 533–534. https://doi.org/10.1016/j.jaad.2024.04.064