Benzoyl Peroxide and Malignancy Risk: A Systematic Review

Key Takeaways

• Benzoyl peroxide use for acne was not associated with a statistically significant increase in malignancy risk, including hematologic cancers, in this review.
• Potential exposure misclassification and limited detail on dosage, duration, and cumulative use restricted how precisely exposure could be assessed.
• These limitations constrained dose-response analysis, and uncertainty around benzoyl peroxide safety remains part of the broader discussion.

Amid ongoing concerns about benzene formation from benzoyl peroxide under certain conditions, the investigators did not identify a statistically significant increase in cancer risk among users. The pooled analyses across outcomes consistently showed no significant association.

Published in the Journal of Drugs in Dermatology in 2026, this systematic review and meta-analysis focused on topical benzoyl peroxide exposure in acne treatment. The investigators assessed associations with leukemia, acute myeloid leukemia, lymphoma, other hematologic malignancies, and selected internal malignancies such as lung cancer. The analysis synthesized observational data rather than mechanistic or experimental evidence.

Across included studies, pooled risk estimates showed no statistically significant differences between benzoyl peroxide users and non-users for leukemia (RR 0.91; 95% CI, 0.68–1.21), acute myeloid leukemia (RR 0.98; 95% CI, 0.67–1.43), lymphoma (RR 0.99; 95% CI, 0.70–1.41), or overall hematologic malignancies (RR 0.99; 95% CI, 0.92–1.06). Limited data on internal malignancies, including lung cancer, also did not demonstrate a significant association. The authors noted important limitations affecting exposure assessment. Potential misclassification may have occurred when exposure was inferred from prescription data or diagnostic coding rather than detailed treatment records. In addition, limited information on dosage, duration, and cumulative exposure reduced the ability to evaluate dose-response relationships and narrowed interpretation of the findings.

While broader safety discussions continue regarding benzene formation under specific conditions, this pooled clinical evidence did not identify a statistically significant association between benzoyl peroxide use and malignancy risk. The findings should be interpreted in the context of observational data limitations and incomplete exposure characterization.