If your acne is severe, painful, or refusing to get lost, you may just be beyond what an over-the-counter treatment can do. Not only can a professional set you up with the really powerful stuff, but also Fitz Patrick explains that “working closely with an aesthetician or dermatologist means you can keep tweaking a routine to make it work best for you.”
Dear acne, you suck. Seriously, we thought the breakouts would be over soon after AP Calculus. But it’s actually something that affects women and men in their 20s and 30s, and even well past their 50s. It’s just not fair (throws childlike temper tantrum). And if you thought blackheads and whiteheads were annoying, the deep painful pimples that often pop up in adult acne are much more aggravating—and harder to get rid of. So, we talked to dermatologists to find out which acne treatments are the most effective on all types of pimples.

^ Jump up to: a b c Zaenglein, AL; Graber, EM; Thiboutot, DM (2012). "Chapter 80 Acne Vulgaris and Acneiform Eruptions". In Goldsmith, Lowell A.; Katz, Stephen I.; Gilchrest, Barbara A.; Paller, Amy S.; Lefell, David J.; Wolff, Klaus (eds.). Fitzpatrick's Dermatology in General Medicine (8th ed.). New York: McGraw-Hill. pp. 897–917. ISBN 978-0-07-171755-7.
Alpha-Hydroxy Acids – These are synthetic acids derived from sugary fruits that remove dead skin cells3 while reducing inflammation. The two common types that can be found in over-the-counter acne treatments are glycolic acid and lactic acid. Another benefit of these acids is that they improve the appearance of your acne scars and make your pores look smaller by stimulating the growth of new, healthy skin.

Dapsone is not a first-line topical antibiotic due to higher cost and lack of clear superiority over other antibiotics.[1] Topical dapsone is not recommended for use with benzoyl peroxide due to yellow-orange skin discoloration with this combination.[10] While minocycline is shown to be an effective acne treatment, it is no longer recommended as a first-line antibiotic due to a lack of evidence that it is better than other treatments, and concerns of safety compared to other tetracyclines.[88]

Dermal or subcutaneous fillers are substances injected into the skin to improve the appearance of acne scars. Fillers are used to increase natural collagen production in the skin and to increase skin volume and decrease the depth of acne scars.[145] Examples of fillers used for this purpose include hyaluronic acid; poly(methyl methacrylate) microspheres with collagen; human and bovine collagen derivatives, and fat harvested from the person's own body (autologous fat transfer).[145]
Acne vulgaris and its resultant scars have been associated with significant social and academic difficulties that can last into adulthood, including difficulties obtaining employment.[30][177] Until the 1930s, it was largely seen as a trivial problem among middle-class girls – a trivial problem, because, unlike smallpox and tuberculosis, no one died from it, and a feminine problem, because boys were much less likely to seek medical assistance for it.[165] During the Great Depression, dermatologists discovered that young men with acne had difficulty obtaining jobs, and during World War II, some soldiers in tropical climates developed such severe and widespread tropical acne on their bodies that they were declared medically unfit for duty.[165]

Those with dry skin can experience flaking and skin that feels tight. Dehydration is one cause of dry skin, so be sure to drink plenty of fluids. Also stay away from alcohol and caffeine, which can draw fluid from your body. Exfoliating daily with a product that is non-abrasive will help with skin cell turnover without erasing your skin’s natural oils. Look for moisturizers that contain hyaluronic acid (also listed as sodium hyaluronate in the ingredients list), glycerin, and algae, which is a marine component that can attract water and send it to your skin cells. Emollients like camellia oil and squalene are great to smooth and hydrate your skin.


Considerations: Side effects are generally mild and short lived. Most common, in 1-5% of people are itching, burning, stinging, and tingling. Other side effects were reported in less than 1% of people. There have been a few reports from darker skinned people of lightening of the skin. Azelaic acid has not been well studied in people with dark complexions.1

The three-piece set doesn’t come with a sun protection treatment, but Paula’s Choice has one in the line, the Clear Ultra-Light Daily Fluid SPF 30+. “Sun protection is really important, especially with acneic skin,” says Townsend. “In many cases, stronger acne products can make the skin photosensitive to the sun.” This isn’t your normal gloppy white sunscreen. Its fluid formula slips over tender skin, doesn’t need a ton of rubbing in, and also leaves a mattifying finish.
Many doctors treat whiteheads, blackheads, or pimples, with either a prescription for an antibiotic or prescription strength benzoyl peroxide or both. These treatments are harsh for mild to moderate problems. If you have an exceptionally deep skin infection causing nodules or cysts, you should be given a referral to a dermatologist. This is also true if you have an aggressive form of acne that causes blemishes to grow together all over your upper body (acne conglobata). You will probably need laser therapy or surgical reconstruction procedures if you have this rare condition.
How to Handle It: Pair two of the best-known acne-fighting ingredients, salicylic acid and benzoyl peroxide, in the week leading up to your period. (If you're feeling bloated, now's the time to do it.) The combo can help prevent hormonal acne from happening in the first place. Zeichner suggests following a salicylic acid wash, like fan-favorite Neutrogena Oil-Free Acne Wash Pink Grapefruit Facial Cleanser ($7), with a benzoyl peroxide spot treatment, such as Murad Acne Spot Fast Fix ($22). If you're still seeing zits, "visit your dermatologist to discuss prescription options, like birth control pills, oral spironolactone — which blocks oil — or topical Aczone 7.5 percent gel," says Zeichner. "It's shown to be particularly effective in adult women without causing irritation." Oral contraceptives level out those hormone fluctuations, keeping your oil production normal and your skin clear.
If you're a fan of the Allure-editor approved Kate Somerville EradiKate Spot Treatment, you'll love its creamy, whipped wash sister from the same mister. The cleanser—which magically foams up when wet—is formulated with 3 percent sulfur to tackle breakouts (including those hard-to-handle cystic acne flare-ups) and rice-bran extract to soothe red, itchy skin.
How to Handle It: Consider salicylic acid your secret weapon. "This beta hydroxy acid helps remove excess oil and exfoliate dead cells from the skin's surface to keep pores clear," says Zeichner. Try Clinique's Acne Solution Clearing Gel, a two-time Best of Beauty winner that packs both salicylic acid and sea whip extract — an ingredient with skin-soothing properties — to help counteract the dryness sometimes caused by salicylic acid. The formula does double duty: It works as a spot treatment for mild to moderate acne and as a nightly allover treatment for pimple prevention. And since it dries clear, you can wear it to fight zits whenever, wherever.
The cleanser and powerful acne treatment in a single formula are designed to treat and prevent breakouts in just one easy step. It’s a deep-cleaning, oil-free formula for cleansing deep into your pores to help anyone, with any skin type, get rid of acne. With only 2% salicylic acid, this gentle formula has special skin soothers that help prevent irritation and over-drying, leaving your skin feeling soft and smooth without the oiliness.
Benzoyl Peroxide – A strong compound that kills the bacteria that causes acne1. It also gets rid of excess oil and the build-up of dead skin cells which clog your pores. This ingredient is exceptionally strong, and it can cause some side effects like redness, dry skin, burning or stinging and scaling. You’ll only find it in products at 2.5% to 10% strength. However, dermatologists recommend that adults stick to a low-dose of benzoyl peroxide, at around 3% for minimal irritation and to avoid bleaching your skin, hair or clothing.

@ brazen i also get exposed to sunlight a lot and would recommend Cetaphil as it has no photosensitive effects. I use Cetaphil wash and it has really been a great help with my acne. it cleans your skin thoroughly while still being gentle. i would recommend using this with a cleansing brush (clarisonic, luna, spin brush etc) and following with a toner preferably one with witch hazel. these combination of things has worked wonders for my skin. 3 months down the line the improvement has been fantastic. All I’m dealing with now is the scars (Hyperpigmentations).
For daily washing, use cleansing products that are designed to care for your skin type. The composition of these funds should not contain soap, dyes and flavors, as well as components such as sodium lauryl sulfate and parabens. All these substances can cause redness, irritation, stimulate the formation of acne. You cannot use a usual soap, it only dries the skin. Gels or foams, which contain acids, are perfect for oily skin prone to imperfections. It does not matter where you buy a cleansing gel or tonic – in a pharmacy or in the nearest supermarket. It doesn’t matter how much money you spend on it. It is important that the acne remedy works.
The third phase of the life cycle of acne is inflammation. At this point, your body’s immune system may deal with the problem, but if it doesn’t, different bacteria can move into the pore. Detecting an enemy bacterial invader, your body responds by emitting white blood cells to the infected area. In some cases, the white blood cells have a difficult time fighting the bacteria, and some die, contributing to the oily buildup and creating pus.
Although home remedies are generally convenient and popular, some have significant counterproductive effects on the skin. The famous Procter & Gamble product Ivory Soap is probably the world’s most frequently used acne face wash ingredient. It is also probably the world’s worst acne face wash ingredient. Often advertised as “so pure that it floats,” Ivory Soap is depicted with pictures of babies and fair-skinned blondes to imply that it is a good and inexpensive face wash for acne-affected skin. Nothing could be farther from the truth.
Many skin conditions can mimic acne vulgaris, and these are collectively known as acneiform eruptions.[27] Such conditions include angiofibromas, epidermal cysts, flat warts, folliculitis, keratosis pilaris, milia, perioral dermatitis, and rosacea, among others.[19][72] Age is one factor which may help distinguish between these disorders. Skin disorders such as perioral dermatitis and keratosis pilaris can appear similar to acne but tend to occur more frequently in childhood, whereas rosacea tends to occur more frequently in older adults.[19] Facial redness triggered by heat or the consumption of alcohol or spicy food is suggestive of rosacea.[73] The presence of comedones helps health professionals differentiate acne from skin disorders that are similar in appearance.[8] Chloracne, due to exposure to certain chemicals, may look very similar to acne vulgaris.[74]
Topical antibiotics deemed safe during pregnancy include clindamycin, erythromycin, and metronidazole (all category B), due to negligible systemic absorption.[46][137] Nadifloxacin and dapsone (category C) are other topical antibiotics that may be used to treat acne in pregnant women, but have received less study.[46][137] No adverse fetal events have been reported from the topical use of dapsone.[137] If retinoids are used there is a high risk of abnormalities occurring in the developing fetus; women of childbearing age are therefore required to use effective birth control if retinoids are used to treat acne.[19] Oral antibiotics deemed safe for pregnancy (all category B) include azithromycin, cephalosporins, and penicillins.[137] Tetracyclines (category D) are contraindicated during pregnancy as they are known to deposit in developing fetal teeth, resulting in yellow discoloration and thinned tooth enamel.[1][137] Their use during pregnancy has been associated with development of acute fatty liver of pregnancy and is further avoided for this reason.[137]
^ Hay, RJ; Johns, NE; Williams, HC; Bolliger, IW; Dellavalle, RP; Margolis, DJ; Marks, R; Naldi, L; Weinstock, MA; Wulf, SK; Michaud, C; Murray, C; Naghavi, M (October 2013). "The Global Burden of Skin Disease in 2010: An Analysis of the Prevalence and Impact of Skin Conditions". The Journal of Investigative Dermatology. 134 (6): 1527–34. doi:10.1038/jid.2013.446. PMID 24166134.

Keep in mind that even if some products market themselves toward severe acne breakouts, all the kits we looked at are definitely designed for mild to moderate acne. Not sure if you fit on that scale? You’re not alone! When you’re in the middle of a breakout, all acne seems severe, so it can be difficult to self-diagnose your symptoms. We talked to dermatologists and cosmetic chemists to better understand the differences between the various types of acne (see below).

Conversely, not using any facewash on your skin leaves you with the build-up of dead skin cells, dirt, grime and excess oils. While many others swear by using the simple combination of warm water and a facial cloth for their skincare routine, warm water isn’t always enough to penetrate your oil-clogged pores that have dirt and bacteria trapped inside. If you think you might disagree, imagine rinsing an oily, used frying pan with just warm water. Without a proper cleanser, you can’t cut into the grease buildup or eliminate harmful bacteria. The same applies for your skin.
This dermatologist-tested formula is a foaming face wash that works incredibly fast. It can make skin visibly clearer in as little as 12 hours. It’s made with 2% salicylic acid, Acceladerm Technology™, and PHAs, polyhydroxy acids that open pores, improve skin moisturization and calms the skin. It unblocks pores, kills bacteria and calms and soothes the skin. This Clearasil product is guaranteed to be so good that if it doesn’t work for you, they have a 30-day money-back guarantee that you can take them up on.
Skin type, tone, and condition vary from person to person. That explains why what worked for your best friend hasn’t helped you at all. If you are at the end of your rope with your acne and find that it is affecting your life, you really should see a dermatologist before struggling to find a new treatment. A dermatologist might still have to try a few different approaches, but they are trained to get through the process quicker. However, if your acne hasn’t caused you serious problems yet, visiting a dermatologist can be a time-consuming and expensive option. This is why many doctors say mild- to moderate- acne can be treated with over-the-counter products.
Aside from the obvious fact that a good face wash can help heal acne and pimple-prone skin, your choice of facial cleanser really matters when you’re trying to get rid of acne. For starters, the wrong face washes can cause acne, or at least, make yours a lot worse. Throughout the day, your skin does come into contact with a lot of dirt and grime, and it also secretes sebum – an oily, waxy, fatty substance that keeps your skin waterproof and lubricated. Oily skin is the result of an excessive amount of sebum secretion, and most soaps are designed to remove that oil from your skin. However, your skin actually needs some of that sebum to function normally. Without it, you end up with dry skin that tightens to create clogged pores and, ultimately, acne.
Although home remedies are generally convenient and popular, some have significant counterproductive effects on the skin. The famous Procter & Gamble product Ivory Soap is probably the world’s most frequently used acne face wash ingredient. It is also probably the world’s worst acne face wash ingredient. Often advertised as “so pure that it floats,” Ivory Soap is depicted with pictures of babies and fair-skinned blondes to imply that it is a good and inexpensive face wash for acne-affected skin. Nothing could be farther from the truth.
Genetics is thought to be the primary cause of acne in 80% of cases.[2] The role of diet and cigarette smoking is unclear, and neither cleanliness nor exposure to sunlight appear to play a part.[2][13][14] In both sexes, hormones called androgens appear to be part of the underlying mechanism, by causing increased production of sebum.[5] Another frequent factor is excessive growth of the bacterium Propionibacterium acnes, which is normally present on the skin.[5]
Frequently used topical retinoids include adapalene, isotretinoin, retinol, tazarotene, and tretinoin.[46] They often cause an initial flare-up of acne and facial flushing, and can cause significant skin irritation. Generally speaking, retinoids increase the skin's sensitivity to sunlight and are therefore recommended for use at night.[1] Tretinoin is the least expensive of the topical retinoids and is the most irritating to the skin, whereas adapalene is the least irritating to the skin but costs significantly more.[1][84] Tazarotene is the most effective and expensive topical retinoid, but is not as well-tolerated.[1][84] Retinol is a form of vitamin A that has similar but milder effects, and is used in many over-the-counter moisturizers and other topical products.
Hydroquinone lightens the skin when applied topically by inhibiting tyrosinase, the enzyme responsible for converting the amino acid tyrosine to the skin pigment melanin, and is used to treat acne-associated postinflammatory hyperpigmentation.[34] By interfering with new production of melanin in the epidermis, hydroquinone leads to less hyperpigmentation as darkened skin cells are naturally shed over time.[34] Improvement in skin hyperpigmentation is typically seen within six months when used twice daily. Hydroquinone is ineffective for hyperpigmentation affecting deeper layers of skin such as the dermis.[34] The use of a sunscreen with SPF 15 or higher in the morning with reapplication every two hours is recommended when using hydroquinone.[34] Its application only to affected areas lowers the risk of lightening the color of normal skin but can lead to a temporary ring of lightened skin around the hyperpigmented area.[34] Hydroquinone is generally well-tolerated; side effects are typically mild (e.g., skin irritation) and occur with use of a higher than the recommended 4% concentration.[34] Most preparations contain the preservative sodium metabisulfite, which has been linked to rare cases of allergic reactions including anaphylaxis and severe asthma exacerbations in susceptible people.[34] In extremely rare cases, repeated improper topical application of high-dose hydroquinone has been associated with an accumulation of homogentisic acid in connective tissues, a condition known as exogenous ochronosis.[34]
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