2025-10-29 10:12:34
Presenters: Doyon VC,1 Rahman S,2 Kharel A,2 Li MK3
Affiliations: 1Department of Dermatology, Centre Hospitalier de l’Université de Montréal, QC, Canada; 2Faculty of Medicine, University of Alberta, AB, Canada; 3Department of Dermatology and Skin Science, Faculty of Medicine, University of British Columbia, BC, Canada
Objective: We sought to examine the differences in responses to benzoyl peroxide safety concerns between health science professionals and the general public following a report on benzene decomposition at high temperatures, identify differences in misinformation prevalence and disclosure regarding benzene exposure between health science professionals and the public, and identify differences in recommendations for benzoyl peroxide use between health science professionals and the public.
Introduction: Concerns about benzoyl peroxide (BPO) safety arose following a report in March 2024 showing BPO decomposition into benzene at high temperatures.1 This crosssectional analysis examines reactions on TikTok from health science professionals (HSPs) and the public, assessing whether this impacted clinical recommendations.
Methods: 154 TikTok posts from January 5 to May 5, 2024, were identified using the query “benzoyl peroxide safety” (and other related synonyms). The posts were analyzed independently by two authors. Quality of the TikTok posts were assessed using the Global Quality Scale, a 5-point Likert scale used in social media to assess structure, flow, and quality of digital health content.2
Results: Forty-three percent of posts were produced by HSPs, including dermatologists (28%), other physicians (6%), nurses/physician assistants (5%), and cosmetic chemists (4%). Fifty-seven percent were produced by members of the public who did not have a bachelor’s degree or higher in health sciencerelated fields. HSPs produced higher-quality posts, with 60.6% scoring GQS 4- 5 versus 14.8% of public posts (p<0.001). Posts by the public were more likely to include high levels of misinformation (26.1% vs. 3.0%, p<0.001) and negative views on BPO (48.5% vs. 18.2%, p<0.001). While HSPs more frequently disclosed benzene risks (86.4% vs. 13.6%, p=0.002), they had mixed views on BPO’s carcinogenic potential (24.6% vs. 7.1%, p=0.02) or stated that there was no carcinogenic risk in typical conditions (52.6% vs. 32.1%, p=0.04). The public more often agreed with the Valisure report (61.2% vs. 23.6%, p<0.001) and recommended stringent measures or avoidance (50.9% vs. 19.0%, p<0.001), while HSPs recommended moderate precautions (24.1% vs. 9.1%, p=0.04).
Conclusion: Most dermatologists and HSPs did not describe a substantial benzene risk with typical BPO use, emphasizing mild precautionary measures are sufficient to minimize potential risks. This is consistent with recent studies revealing no elevated blood benzene levels nor increased malignancy risk.3,4
References:
1 Kucera K, Zenzola N, Hudspeth A, Dubnicka M, Hinz W, Bunick C, Dabestani A, Light D. Benzoyl peroxide drug products form benzene. Environ Health Perspect. 2024;132(3):037702.
2 Bernard A, Langille M, Hughes S, Rose C, Leddin D, Veldhuyzen Van Zanten S. A systematic review of patient inflammatory bowel disease information resources on the world wide web. Am J Gastroenterol. 2007;102(9):2070-2077.
3 Sadr N, Troger A, Chai PR, Barbieri JS. No evidence for an association between benzoyl peroxide use and increased blood benzene levels in the National Health and Nutrition Examination Survey. Journal of the American Academy of Dermatology. 2024;91(4):763- 765.
4 Garate D, Thang CJ, Lai J, Golovko G, Wilkerson MG, Barbieri JS. 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. 2024;91(5):966-968.
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