Must-read JDD Letter to the Editor: Pooled analysis finds no significant association between benzoyl peroxide use for acne and risk of hematologic or internal malignancies
This JDD “Letter to the Editor” for the May issue summarizes a systematic review and meta-analysis examining whether benzoyl peroxide use for acne is associated with malignancy risk. The authors searched PubMed, Embase, and Web of Science following PRISMA guidance and pooled data from four studies encompassing more than four million patients to evaluate risks of leukemia, acute myeloid leukemia, lymphoma, any hematologic malignancy, and selected internal cancers including lung cancer.
Across pooled analyses, no statistically significant associations were found for leukemia, with a pooled relative risk of 0.91 and confidence intervals that crossed unity. Similar null findings were reported for acute myeloid leukemia and lymphoma, and the single study reporting internal malignancy and lung cancer likewise did not show an increased risk. Heterogeneity was present in some analyses, and the authors emphasize that their results describe associations rather than proving absence of any rare risk.
Important limitations to note for clinical practice and counseling include potential exposure misclassification in the included studies, limited data on dose, duration, and cumulative exposure to benzoyl peroxide, and variation in study methods that constrained dose response assessment. The analysis does not directly address scenarios of benzene contamination under extreme conditions or product misuse, and it does not replace continued vigilance in product safety surveillance.
For dermatology clinicians and HCPs, the pooled evidence in this Letter suggests no detectable increase in hematologic or internal malignancy risk associated with benzoyl peroxide use for acne in the studied populations.
Read the full JDD “Letter to the Editor” in the May issue for details on study selection, pooled estimates, forest plots, and the authors discussion of implications and limitations before changing counseling or practice.
Blog write-up assisted by AI
