All products are independently selected by our editors. If you buy something, we may earn an affiliate commission.
There are so many different ways to treat acne breakouts that it can be hard to figure out exactly which might be the best acne treatment for your skin. Even if you’ve had some type of acne all your life, the pimples we have as adults can be different from the acne we had as teens and can be difficult to clear up, depending on things like hormones, changes in skin type and texture, and scarring.
Since life is hard enough without worrying endlessly about the state of our skin, SELF spoke to dermatologists to find out which acne treatments are the most effective— on all types of pimples. Keep reading to learn what causes acne in the first place, plus the best acne treatments and acne medications worth spending your hard-earned dollars on.
It’s worth noting that whether you’re looking to simply minimize some pesky blackheads or you’re dealing with something more serious like cystic or inflammatory acne, your best bet is always to speak to a dermatologist. They’ve got the training to identify acne types by sight and access to way more treatment options than your local Target or Ulta. (We’re not knocking over-the-counter topicals here, they’re still a darn good option, but your local dermatologist has the goods, trust us.)
What causes acne?
For starters, you can’t fight what you don’t understand. So how does acne show up on your skin in the first place? Pimples form when the oil and dead skin cells on your skin combine to form a plug that blocks the pores, according to the Mayo Clinic.
Sometimes the bacteria Cutibacterium acnes (sometimes called Propionibacteria acnes) also gets trapped in the pore, where it multiplies. “As the P. acnes bacteria that naturally live on skin overgrow within this plugged follicle, the area becomes inflamed, and this is when you start to see papules, pustules, and cystic lesions,” dermatologist Sejal Shah, M.D., tells SELF.
What actually works for acne?
The good news is that there are a lot of options for treating acne and lots of products and ingredients that work really well— as the AAD points out, today, nearly every type of acne has an effective treatment available. The tricky part, and the part where the help of a dermatologist is always a good idea, is figuring out what type of acne you’re dealing with and ensuring that the treatments you use aren’t going to make a bad situation any worse.
Best Acne Treatments
Below are the best acne treatments for occasional, mild, and some moderate acne.
- Salicylic Acid
- Glycolic Acid
- Benzoyl Peroxide
- Lactic Acid
- Retinol
- Retinal
- Adapalene
- Sulfur
- Bakuchiol
- Dapsone Gel
- A Cortisone Shot
- Birth Control Pills
- Spironolactone
- Tazarotene
- Isotretinoin
- Azelaic
- Antiobiotics
Salicylic acid is the go-to fix for pimple remedies in teens. And cruising through the skincare aisles at the drugstore, you’ll find it as the active ingredient on the majority of products labeled “acne wash” or “spot treatment.” Salicylic acid works by reducing swelling and unclogging pores to help pimples shrink and then disappear.
Salicylic acid also has anti-inflammatory properties to help with inflamed cystic breakouts that can occur when blockages deep in the hair follicles rupture beneath the skin. Although it’s totally fine to use salicylic acid in a face wash, you may find that you have better results when using it as a toner, moisturizer, or leave-on spot treatment because these give it more time to do its work. And keep in mind, salicylic acid can dry out the skin if over-applied, so it may be wise to choose only one product with the ingredient to use every day.
Products to try:
Glycolic acid is an alpha hydroxy acid (AHA) that gently exfoliates the skin, helping to get rid of the dead skin cells that can clog pores. As with salicylic acid, you can find glycolic acid in washes, peels, moisturizers, and serums at your local beauty store or drugstore.
Product to try:
Benzoyl peroxide is an antibacterial ingredient, and it’s very effective at killing the C. acnes bacteria that causes breakouts. But benzoyl isn’t without its downsides. The leave-on creams and cleansing treatments can dry out sensitive skin and bleach clothing if you aren’t careful. Board-certified dermatologist Eric Meinhardt, M.D., previously told SELF that it’s best to stick to formulations that have no more than 2% benzoyl peroxide listed on the active-ingredients chart; stronger concentrations are harder on your skin without being any tougher on bacteria.
Products to try:
Like glycolic acid, lactic acid is an AHA, which means it works like a chemical exfoliant on the skin. However, it’s generally gentler than glycolic acid, so it’s a good option for people who want to use an exfoliating acid but have more sensitive skin. Lactic acid is also a humectant, which means it draws water to itself and can be hydrating. So for those with dry or sensitive skin, exfoliants with lactic acid would work well without being too irritating. These products can work for a chemical peel at home. (You can also try a derm-approved moisturizer for acne-prone skin!)
Products to try:
You’ve probably heard of the benefits of retinoid creams for anti-aging, but these forms of vitamin are also efficient at clearing up acne. “[Retinoids] cause skin cells to turn over at a faster rate, decrease oil production, and help skin exfoliate,” board-certified dermatologist Rita Linkner, M.D., tells SELF. Another benefit: Acne is inflammation, and retinoids are anti-inflammatory.
Shah often recommends over-the-counter retinol or prescription retinoids to her acne-prone patients. “I find that, compared with other treatments, they are beneficial for not just treating acne but also preventing new acne from forming as they help prevent that initial stage of the follicle getting clogged,” she says. “They can also help with some of the post-acne [problems], such as hyperpigmentation.”
But keep in mind that retinoids can also be irritating, and if you have sensitive skin (or a skin condition like psoriasis, eczema, or rosacea), even an over-the-counter option may be too strong. So it’s important to always start with a retinol for sensitive skin such as a low concentration of retinol (even as low as .01%) to see how your skin reacts. Your dermatologist can also recommend an over-the-counter retinol with a low concentration or a low-concentration version of prescription retinoids, which you might be able to tolerate more easily. And retinol is not considered safe for pregnant or breastfeeding people, so keep that in mind, too.
Retinol also isn’t a quick fix. It takes time to see results (possibly a few months), and it’s something you’ll have to keep using to maintain its benefits.
Retinol isn’t the only over-the-counter retinoid out there—or the gentlest. In fact, some experts recommend that those with sensitive skin opt for products containing retinal (also called retinaldehyde) instead of traditional retinol. Like retinol, this compound is a naturally occurring retinoid that the body converts to retinoic acid. And, as SELF explained previously, it has been shown in a few studies to be just as effective as retinol and other retinoids with fewer side effects.
Products to try:
Adapalene—often known by the brand name Differin—is a synthetic retinoid that used to be available only via a prescription. But it recently became available over-the-counter, which makes it a great, strong acne medication that you can access without a prescription. And because it’s synthetic, it was formulated to be gentler than other prescription acne medications. For those who’ve graduated beyond over-the-counter retinol but aren’t quite ready for the full intensity of a prescription retinoid, adapalene is a perfect choice.
Products to try:
Warning: Sulfur smells like rotten eggs. But it is an effective ingredient at drying up pus-filled pimples and whiteheads (you’ve gotta take the good with the bad). It works by sucking up the oil. Sulfur is typically mixed with other active ingredients to get the most efficacy and with fragrances to mask the strong scent. You can often find it in masks and spot treatments.
Products to try:
This ingredient, which is a plant-based extract often billed as a retinol alternative, is not actually a retinoid at all. But in a few limited studies on Bakuchiol, it did show promise in managing things like skin texture and fine lines—without the side effects we usually associate with retinoids. Today it might show up in a product all on its own or be paired with a low concentration of retinol to help boost the acne-fighting and antiaging effects without increasing the risk for side effects. As a solo ingredient, Dr. Adotama recommends it to those looking for more natural remedies for acne. Bonus: recent research indicates it’s particularly well suited for acne on skin of color.
And here are the best acne treatments for more severe acne (many of these will require a prescription!).
One option your dermatologist might prescribe for acne is dapsone gel, such as the brand-name version Aczone. Dapsone is both antimicrobial and anti-inflammatory, and it’s proven to help get rid of blackheads, whiteheads, and deeper painful pimples. Oftentimes dapsone is used alongside other acne treatments. And as with many of those other remedies, this can cause skin to dry out.
Cortisone is a quick fix for acne emergencies, especially large cystic acne bumps. Go to the dermatologist’s office for a shot of this corticosteroid, and the pimple will dramatically lessen and possibly even disappear in 24 to 48 hours. The treatment works to curb inflammation, which makes it best for cystic breakouts and can be really good at combating hormonal acne flare-ups.
However, if done incorrectly, a cortisone shot can leave a small depression in the skin that lasts about eight weeks. “It’s a rare side effect that happens if the dosage of cortisone is too high,” Dr. Linkner explains. “You want to go to someone who knows what they’re doing.” So this method is best saved for those rare emergencies and should not be considered a long-term treatment for your acne.
If you notice that you’re breaking out right around your period every month, your acne might be linked to hormones. When it comes to hormonal acne, “a sensitivity to the hormones called androgens manifests in the form of cystic acne,” say Dr. Linkner. Androgens, namely testosterone, cause the skin to produce more sebum. More sebum equals more acne. Combination hormonal birth control, which contains the hormones estrogen and progestin, helps keep hormones balanced and skin clear. Ortho Tri-Cyclen, Estrostep, and YAZ are all FDA-approved as acne treatments.
Sometimes birth control alone isn’t enough to really make a difference in hormonal acne. That’s when your doctor might recommend adding in an androgen blocker such as spironolactone. Spiro (as it’s often called) minimizes the amount of androgen hormones in circulation by blocking the receptors that bind with testosterone. When these pills are taken at the same time as an oral contraceptive, many women see an improvement in breakouts, according to Dr. Linkner. The drug is sometimes prescribed to women with polycystic ovarian syndrome (PCOS) to relieve androgen-related symptoms like excessive hair growth, hypertension, oily skin, and acne.
Also known by the brand name Tazorac, this is another powerful prescription retinoid, but it’s synthetic. Like other retinoids, it can cause side effects like dryness and irritation, so you should always follow your dermatologist’s instructions for when and how to use it. Interestingly, it can also be used to help manage plaque psoriasis and may be combined with other topical medications, like corticosteroids, to do just that.
Isotretinoin (formerly sold as Accutane) is a particularly strong retinoid. It has a mixed reputation, but among dermatologists it’s the finisher for patients with severe acne. “If you have an acne patient that doesn’t respond to anything, [isotretinoin] can really be a game changer,” board-certified dermatologist Adam Friedman, M.D., tells SELF. Commonly referred to as Accutane even though that particular brand was discontinued, isotretinoin is an oral retinoid, and it has all the benefits of a topical retinol but is even more effective.
It’s especially good for cystic acne in women and body acne, including back acne in adult men. “Oral vitamin A basically shuts down your sebaceous glands. If you suppress [them] for a long enough period, you can cure someone of their acne, and about 50% do hit that cure rate,” Dr. Linkner says. A course of isotretinoin can take six to nine months. Sometimes patients need to repeat the course at a higher dosage in order to truly eliminate acne.
But isotretinoin has mixed reviews for a reason. It makes the skin super dry and sensitive, which means it’s important to keep moisturizers, lip balm nearby, and other dry skin products while you’re on the treatment. Oh, and don’t even think about waxing your eyebrows (just imagine your skin ripping off).
There’s another downside to isotretinoin: It requires a lot of paperwork and office visits. Since isotretinoin can cause birth defects, you have to come into the dermatologist’s office once a month to get a pregnancy test and take a lengthy survey with questions about your sex life to prove that you are using sufficient birth control. These precautions are intense, but dermatologists agree that the final results for isotretinoin are like no other. “This is one of the few medicines that I can look [patients] in the eye and guarantee them it will work,” Dr. Friedman says.
Dermatologists aren’t sure why azelaic acid is so effective at clearing up inflammation, but it’s often used as an option for sensitive skin or pregnant patients. The ingredient is good at treating melasma, acne, and the bumps associated with rosacea, Dr. Linkner says. Your dermatologist can prescribe products with high concentrations of azelaic acid, and you can find over-the-counter options with lower concentrations of this active ingredient.
Products to try:
A dermatologist can prescribe oral antibiotics to help with acne, but it’s not typically the first choice. While you might see immediate results, the acne will return as soon as you get off of the antibiotics. And Dr. Linkner warns, “While you’re on them, [you can get] yeast infections, nausea, upset stomach.” That said, antibiotics can be a very effective first step, particularly with acne found on parts of the body other than the face. “Back acne can sometimes be difficult to treat, mainly because of the location,” says Dr. Adotama. “Not everyone has someone that can apply topical medications to their back and so some patients might need oral antibiotics a little sooner in order to control the acne on the back.” So, if body breakouts are a concern of yours and you don’t have someone to help you slather creams onto those difficult to reach spots, antibiotics might be the right step on your acne treatment journey.
The bottom line: Acne is a pain no matter your age—but you don’t have to live with it. If over-the-counter treatments aren’t working for you, talk to your dermatologist, who can determine the best acne medication for you.
How can I clear up acne fast?
Unfortunately, there’s no magic wand you can wave to make your acne disappear. As Prince Adotama, M.D., a board-certified dermatologist and an assistant professor at the NYU Grossman School of Medicine, tells SELF, you can’t rush acne treatments. “It takes, on average, two to three months—or sometimes even longer—to really start seeing the benefits of acne medications,” he says. “So I always tell my patients to be patient with the regimen. The regimen that we give you will work, but you have to be patient and you have to keep at it. Trying a medication for a week and saying it doesn’t work is just destined for failure.”
Should I consult a dermatologist for acne?
The fastest way to get to the root of the cause of your acne and find the most reliable treatment plan is to get in touch with a dermatologist. Why? Simply put, dermatologists can take the guesswork out of a treatment in a way a trip to your drugstore can’t, even if you’re armed with all the skincare knowledge the internet can offer. “Inflammation, stress, genetic predisposition, hormones, environmental factors, all these different factors play a role in the development of acne,” says Dr. Adotama. “Due to our extensive training, dermatologists can appropriately diagnose acne based on its clinical appearance: a patient’s morphology, the type of lesions, whether it be comedones, blackheads, whiteheads, or pustules, the location on the face, all of that will help us to be able to make a specific diagnosis.”
Once you meet with a derm, they can recommend the right treatment plan, and you’ll be on the right path to your best skin ever. So while there really isn’t a quick fix to getting rid of acne, consider a dermatologist to be your skincare fairy godmother who’s got the magic powers to clear up your acne faster than you ever could on your own.
How do dermatologists treat acne?
To start, a dermatologist will want to get an idea of your skin’s history and what you’re looking for in terms of treating your skin, including any procedures or ingredients you might not be comfortable with. “We want to find out what’s best for you so we’ll ask you about skin type—if it’s oily, if it’s combination—we ask about the products that you use at home,” says Dr. Adotama. “I specifically like to talk with clients to see what they feel comfortable with. Some clients don’t want to take pills, some clients want natural-only products. I’m willing to work with my patients to make them feel comfortable with their treatment options.” (File this under yet another reason it’s worth making a trip to a derm.)
Once your doc knows a little bit about your skin type and your lifestyle, they will get to work identifying which of the types of acne you’re dealing with in order to map out your course of treatment. According to Dr. Adotama, “we treat differently depending on what we see, so, if the acne is mainly blackheads and whiteheads or non-inflammatory acne, we might go topical. But if the acne is really inflamed and cystic, then we often use oral medications so the type of acne we see will dictate how we approach that medication management.”
Treatment often depends on the severity of your acne, which the American Academy of Dermatology usually classifies as mild, moderate, or severe. Depending on how intense your acne is, along with your skin type and any other concerns you have, you may be prescribed topical medication, oral medication (or both). Here’s the difference between these types of treatment options, per the AAD:
• Topical acne treatment: This is the most common type of acne treatment. Some work by killing acne-causing bacteria while others get rid of acne by decreasing oil. The ingredients in topical acne treatments may include retinoids, benzoyl peroxide, antibiotics, or salicylic acid.
• Oral acne treatment: These medications, which work internally to combat acne, are best for cystic acne treatment (which are those red, swollen pimples known as acne cysts and nodules). They can come in different forms such as antibiotics (which kill bacteria and decrease inflammation), birth control pills (which are a good hormonal acne treatment), and isotretinoin (commonly referred to as Accutane, even though that specific brand has been discontinued).
Sources:
- Acne: Diagnosis and Treatment, Mayo Clinic
- Isotretinoin: Overview, American Academy of Dermatology
- Oral Spironolactone in Post-teenage Female Patients with Acne Vulgaris, Journal of Clinical and Aesthetic Dermatology
- A Clinical Study Evaluating the Efficacy of Topical Bakuchiol Cream on Facial Acne, Journal of Drugs in Dermatology
- Dual Effects of Alpha-Hydroxy Acids on the Skin, Molecules
- Acne: Symptoms and Causes, Mayo Clinic
- Acne: Who Gets and Causes, American Academy of Dermatology
- Tazarotene Topical, Medline Plus
- Propionibacterium acnes: infection beyond the skin, Expert Review of Anti-infective Therapy
- Salicylic acid: a link between aspirin, diet and the prevention of colorectal cancer, QJM
- Glycolic acid peel therapy - a current review, Clinical, cosmetic and investigational dermatology
Related:
