The Exposed Facial Cleanser is our top pick. This cleanser is one of the very best on the market and it works for all skin types. The gentle yet rich formula is ideal for anyone, and it’s especially good for those with sensitive skin. It’s non-comedogenic, hypoallergenic, and soap free, with just 0.5% salicylic acid. Plus, it’s made with a combination of natural ingredients, including sage leaf extract, and vitamins like pro b5.
Isotretinoin is an oral retinoid that is very effective for severe nodular acne, and moderate acne that is stubborn to other treatments. One to two months use is typically adequate to see improvement. Acne often resolves completely or is much milder after a 4–6 month course of oral isotretinoin. After a single course, about 80% of people report an improvement, with more than 50% reporting complete remission. About 20% of patients require a second course. Concerns have emerged that isotretinoin use is linked with an increased risk of adverse effects, like depression, suicidality, anemia, although there is no clear evidence to support some of these claims. Isotretinoin is superior to antibiotics or placebo in reducing acne lesions. The frequency of adverse events was about twice as high with isotretinoin, although these were mostly dryness-related events. No increased risk of suicide or depression was conclusively found. Isotretinoin use in women of childbearing age is regulated due to its known harmful effects in pregnancy. For such a woman to be considered a candidate for isotretinoin, she must have a confirmed negative pregnancy test and use an effective form of birth control. In 2008, the United States started the iPLEDGE program to prevent isotretinoin use during pregnancy. iPledge requires the woman under consideration for isotretinoin therapy to have two negative pregnancy tests and mandates the use of two types of birth control for at least one month before therapy begins and one month after therapy is complete. The effectiveness of the iPledge program has been questioned due to continued instances of contraception nonadherence.
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.
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