We worked with dermatologists to find the best acne treatments. Our top picks include prescription tretinoin cream and oral antibiotics as well as OTC salicylic acid toners and niacinamide serums.
According to the American Academy of Dermatology, acne affects up to 50 million people in the United States every year. Though it’s the most common skin condition in the United States, determining the best acne treatment for your skin is still challenging.
Acne treatments include prescription medications, such as topical and oral varieties, and over-the-counter (OTC) skin care products.
To narrow the vast list of options, we enlisted the expertise of board certified dermatologists.
While their first recommendation is usually to visit a medical professional who specializes in dermatology, OTC products can treat some mild acne types.
For moderate to severe acne, prescription-strength treatments and the expert advice of a dermatologist may be necessary.
Keep reading to learn what causes acne and the appropriate treatment options for the various types of acne according to the pros.
Prescription options:
- Accutane: Isotretinoin
- Tretinoin: Hers Skin Care
- Personalized treatment: Apostrophe
- Custom subscription: Hims Rx Skincare
- Oral antibiotics: Nurx Acne
- Birth control: Nurx Birth Control
- Spironolactone: Happy Head Oral Spironolactone
- Tazarotene: Generic Tazorac
- Altreno: Altreno
Over-the-counter options:
- Spot paste: Pimple Paste Overnight Blemish Spot Treatment
- Adapalene: Differin Adapalene Gel
- Cleanser: Neutrogena Oil-Free Acne Wash Cream Cleanser
- Lotion: Mario Badescu Drying Lotion
- Spot treatment: La Roche-Posay Effaclar Duo Acne Spot Treatment
- Gel: SkinCeuticals Purifying Cleanser Gel
- Pimple patches: Florence By Mills Spot a Spot Acne Patches
- Serum: The Ordinary Niacinamide 10% + Zinc 1% Oil Control Serum
- Night treatment: The INKEY List C-50 Blemish Night Treatment
- Face oil: Sunday Riley U.F.O. Acne Treatment Face Oil
The cause of acne usually boils down to clogged pores when a mix of sebum, bacteria, and dead skin cells is trapped in a hair follicle.
Each pore on the surface of the skin is the opening to a hair follicle, which is made up of a hair and an oil gland. When working properly, the oil gland releases sebum that travels up the hair and out of the pore. The sebum reaches the skin, where its job is to keep the skin lubricated.
If part of this process goes awry, acne may develop.
Excessive sebum produced by the oil gland, a buildup of dead skin cells, or the accumulation of bacteria can all affect this process and lead to clogged pores that contribute to the formulation of acne.
Determining the best acne treatment for you depends on the type of acne and its severity.
“The best way to determine the right acne treatment plan is to see a dermatology provider,” Julie C. Harper, MD, a board certified dermatologist and clinical associate professor of dermatology at the University of Alabama-Birmingham, told Healthline. “There are many different types of acne, and treatment regimens vary from person to person.”
A dermatologist will closely examine your skin to see which of the different types of lesions appear:
- Mild noninflammatory acne (aka comedonal acne) includes whiteheads and blackheads.
- Moderate inflammatory acne includes papules and pustules.
- Severe inflammatory acne includes nodules and cysts.
OTC products containing active ingredients like salicylic acid and benzoyl peroxide, or prescription-strength topical retinoids, can usually clear noninflammatory acne.
Inflammatory acne requires topical or oral prescriptions from a dermatologist.
Though papules and pustules may clear with OTC products alone, inflammatory acne is more likely to lead to scarring, so visiting a dermatologist is the best way to clear acne and prevent acne scars.
We picked these skin care products after consulting with dermatologists, who helped us select products with ingredients proven to be effective in treating acne.
Our top picks are highly rated by professionals and the public alike. Each product has been vetted by our team for medical and business standards. Learn more here.
Choosing the right acne treatment depends on the following factors:
- Type of acne: Consider whether you have inflammatory acne (papules, pustules, nodules, and cysts) or noninflammatory acne (whiteheads and blackheads). OTC products can typically treat noninflammatory acne. Inflammatory acne may require prescription treatment.
- Acne severity: Mild to moderate acne may be treatable at home, but moderate to severe acne likely requires a visit to a dermatologist for professional advice on the appropriate treatment.
- Skin type: Some acne treatments may be too harsh for sensitive skin. Ingredients like salicylic acid may be too drying for dry skin.
- Underlying health conditions: Check with a doctor before starting a new acne treatment if you have an underlying health condition. Certain ingredients may not be suitable for use during pregnancy, too.
Some people try at-home, OTC solutions for their acne before talking with a doctor. This may be enough for mild to moderate cases but usually isn’t the best option for severe and cystic acne.
Seeing a dermatologist right away is helpful for treating any type of acne the most effectively. This can cut down on irritation from using too many active ingredients and reduce the risk of scarring.
If you haven’t seen improvements within 1 to 2 months of using OTC products, it may be time to make a doctor’s appointment.
While you may not need to see a doctor at the first sight of a whitehead, you can consider seeing a doctor shortly after noticing signs of inflammatory and cystic acne.
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Acne treatments can go a long way, but how you care for your skin outside of these treatments is also important. Here are some ways you can help prevent acne in your regular routine.
Cleansing
The importance of routine facial cleansing for acne can’t be overstated. Acne is caused, in part, by clogged hair follicles. Washing your face regularly helps unclog them.
The American Academy of Dermatology recommends washing your face twice daily with a gentle, nonabrasive cleanser. Use your fingertips and avoid using a washcloth, sponge, or anything that can irritate the skin. It may be tempting to scrub your skin, but the irritation can exacerbate the problem.
Washing too little or too often can be problematic for acne-prone skin. Washing twice a day has been shown to significantly improve open comedones and total noninflammatory lesions, according to a
Washing your hair can also help prevent acne, especially if you have an oily scalp. These oils can also contribute to clogged pores. Just like washing your face, shampooing your hair should be part of your acne-fighting regimen.
Regular facials
In people with mild acne, getting a facial may be an effective method of clearing your skin when done alongside a proper skin care routine. Aestheticians use tools and products that cleanse deeply and remove whiteheads and blackheads.
Moderate to severe cases of acne may require prescription-strength treatments to show signs of improvement. However, facials can still be helpful.
An experienced aesthetician can help treat acne, acne scars, and post-inflammatory hyperpigmentation with treatments like chemical peels, microneedling, and microdermabrasion in addition to standard facials.
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Moisturizing
Face washes are associated with acne-prone skin, and moisturizers are associated with dry skin. However, both are important for all skin types.
A moisturizer provides moisture and hydration for skin, and acne-prone skin can benefit from staying hydrated. Moisturizing also helps reduce inflammation and protect skin from environmental stressors.
Acne is usually accompanied by inflammation, and moisturizing can be soothing. Harsh environment conditions, such as wind, cold temperatures, and humidity levels, can also make matters worse. Applying a layer of moisturizer can help by creating a protective barrier.
When skin is dehydrated, it can overcompensate by producing too much oil. This oil can then clog pores, contributing to breakouts. Moisturizing regularly helps balance the levels of moisture (oil) and hydration (water) in the skin.
If you’re using an acne treatment with ingredients like benzoyl peroxide, salicylic acid, tretinoin, or adapalene, your skin may become dry or irritated. A moisturizer helps make these medications more tolerable.
Those with acne-prone skin should choose their moisturizer carefully. Always choose a moisturizer with noncomedogenic ingredients so it doesn’t clog your pores.
Professional care can help people with moderate to severe cases of acne find relief.
It may be time to seek professional help from a dermatologist if:
- you’ve tried everything and nothing seems to help
- you have recurring breakouts that clear up and return
- you get acne in places like your thighs or upper arms
- your acne is painful and deep under the skin
- your breakouts have been going on for years
- acne affects your confidence, self-esteem, and social life
- your acne may be linked to a new medication you’re taking
- acne leaves dark spots
You don’t have to have severe acne to see a doctor or dermatologist. If you have stubborn acne that won’t go away with OTC products, it may be time to schedule an appointment to discuss prescription-strength acne treatments.
Even if you have a mild case of acne, it may be helpful to visit a doctor regularly to see how your skin progresses with treatment.
Home remedy acne treatments made with ingredients around the house may be questionable, but OTC remedies may help.
Many ingredients in OTC skin care products are proven to treat acne. OTC products containing active ingredients like salicylic acid, benzoyl peroxide, and sulfur can be effective at treating noninflammatory, mild acne at home.
Topical benzoyl peroxide may be just as effective for acne as adapalene or clindamycin (prescription acne treatments).
More severe cases of acne may require prescription-strength products. Some people may need to seek professional help from a dermatologist or acne-experienced aesthetician.
Treating acne takes time. Acne treatments can take 4 to 6 weeks or 2 months or longer to show improvements. If you don’t see improvements in that time frame, try a new treatment or consult a dermatologist.
There may be days when you wake up with a new breakout and have no idea why or what to do. On those days, here are some things you can do to clear up a sudden flux of acne:
- Change your pillowcase to stop the spread of bacteria.
- Use a spot treatment on the affected area.
- Apply ice to reduce swelling and redness or discoloration.
- Use a face mask targeted for acne.
- Avoid picking at your face.
- Moisturize with pure aloe vera to promote wound healing.
Antibiotics often used to treat acne, such as azithromycin and clarithromycin, are usually deemed safe for pregnancy.
OTC ingredients like salicylic acid, benzoyl peroxide, and vitamin C are likely safe too.
Ingredients that may not be safe include retinol, Tazorac, spironolactone, and others. It’s best to check with your doctor before using any new acne treatments during pregnancy.
Insurance may cover topical and oral medications, such as tretinoin cream or oral contraceptives, that are prescribed by a doctor or dermatologist. Coverage varies depending on your insurance plan.
Acne is one of the most common skin conditions in the United States, yet finding an effective treatment can be a mystery sometimes.
Experts agree that OTC skin care products containing ingredients like salicylic acid, benzoyl peroxide, sulfur, azelaic acid, and more may serve as a steppingstone to improve mild to moderate acne.
For moderate to severe acne, a visit to a dermatologist’s office is usually warranted.
Lacey Bourassa is a health, wellness, and beauty writer based in Southern California. She holds a BA in English. Her work has appeared in digital publications like Livestrong, Verywell, Business Insider, Eat This Not That, and others. When she’s not writing, Lacey is likely pursuing her other interests: skin care, plant-based cooking, Pilates, and traveling. You can keep up with her by visiting her website or her blog.
