How to Handle It: Your best bet is benzoyl peroxide. "Benzoyl peroxide can kill acne-causing bacteria and reduce inflammation," says Zeichner. Try a cream like the La Roche-Posay Effaclar Duo Dual-Action Acne Treatment ($37), which also exfoliates with lipo-hydroxy acid. Be aware that it can seriously dry out skin so moisturize well after you use it.
Considerations: Cigarette smoking with oral contraceptive use increases the risk of serious heart disease.2 There are many negative side effects and positive side effects to taking birth control pills for acne. Talk to your doctor to decide if it is right for you.1-3 While it is a widely held belief, evidence does not show a correlation between pregnancy rates and concurrent administration of birth control pills and oral antibiotics. [With the exception of anti-tuberculosis drugs like rifampin.]
For example, if you have acne on dry skin, you need something gentle enough to cleanse and exfoliate but not dehydrate, like a Neutrogena cleanser. If you have oily skin, you’re looking to exfoliate and combat oil production with a product like Cetaphil. If you have combination skin, you need something that can treat your unique skin and balance it out, like Exposed Skin Care.
^ 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.
Combined oral contraceptives. Four combined oral contraceptives are approved by the FDA for acne therapy in women who also wish to use them for contraception. They are products that combine estrogen and progestin (Ortho Tri-Cyclen, Yaz, others). You may not see the benefit of this treatment for a few months, so using other acne medications with it the first few weeks may help.

Acne treatment that you apply to the skin: Most acne treatments are applied to the skin. Your dermatologist may call this topical treatment. There are many topical acne treatments. Some topicals help kill the bacteria. Others work on reducing the oil. The topical medicine may contain a retinoid, prescription-strength benzoyl peroxide, antibiotic, or even salicylic acid. Your dermatologist will determine what you need.

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