But the side effects of targeted breakout cream treatments aren’t always worth it. “So many products instruct consumers to use benzoyl peroxide spot treat red bumps and pustules. I don’t recommend it,” says Dr. Lawrence Green, board-certified dermatologist and assistant clinical professor of dermatology at George Washington University. Such high concentrations of benzoyl peroxide cause added irritation and inflammation to already sensitive skin, so with this in mind, we cut kits that included spot treatments.

If even a trace of sodium lauryl sulfate is left on the skin for more than an hour, however, the upper layer of living skin cells is irritated and dies. Tiny flakes of skin make the texture of the skin look uneven, and they can clog pores. The scent of sodium lauryl sulfate also causes your nose and tongue to be less sensitive to sweet tastes and their associated odors, so you will crave sugar.
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According to Dr. Bailey, the best facial cleansers for acne should have at least one of these key ingredients: salicylic acid, glycolic acid or benzoyl peroxide. Cleansers with these ingredients can penetrate your pores and eliminate pore-clogging impurities—like dead skin cells, makeup, excess oil and bacteria—that irritate skin and make acne worse.
Accutane (isotretinoin) 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, [Accutane] can really be a game changer,” board-certified dermatologist Adam Friedman tells SELF. Accutane is an oral retinoid, and it has all the same benefits of a topical retinol but is even more effective.
The best acne treatment will also include gentle cleanser. Regular bars of soap have harsher cleansers in them that can create problems of their own and encourage bacteria to spread. It is also a good idea to use makeup wipes to clean off any makeup (if you wear it) before you wash your face. Only washing your face without the wipe or wiping your face without the wash is not a good combination. You will either end up missing some of the makeup or you will end up leaving preservatives and other residues on your face.

Comedones (blackheads and whiteheads) must be present to diagnose acne. In their absence, an appearance similar to that of acne would suggest a different skin disorder.[27] Microcomedones (the precursor to blackheads and whiteheads) are not visible to the naked eye when inspecting the skin and can only be seen with a microscope.[27] There are many features that may indicate a person's acne vulgaris is sensitive to hormonal influences. Historical and physical clues that may suggest hormone-sensitive acne include onset between ages 20 and 30; worsening the week before a woman's period; acne lesions predominantly over the jawline and chin; and inflammatory/nodular acne lesions.[1]
Comedones (blackheads and whiteheads) must be present to diagnose acne. In their absence, an appearance similar to that of acne would suggest a different skin disorder.[27] Microcomedones (the precursor to blackheads and whiteheads) are not visible to the naked eye when inspecting the skin and can only be seen with a microscope.[27] There are many features that may indicate a person's acne vulgaris is sensitive to hormonal influences. Historical and physical clues that may suggest hormone-sensitive acne include onset between ages 20 and 30; worsening the week before a woman's period; acne lesions predominantly over the jawline and chin; and inflammatory/nodular acne lesions.[1]
Acne isn’t just a problem for teens. According to studies, those pesky zits and pimples can pop up at any age. Whether it’s your diet, environment or stress that’s to blame, you don’t have to suffer helplessly. To get the skinny on acne, we talked to board-certified dermatologist Cynthia Bailey, M.D., president and CEO of Advanced Skin Care and Dermatology Physicians, Inc. and founder of DrBaileySkinCare.com. Here, she shares her best tips on how to choose the right acne cleanser for you, as well as how to use it to get the best results.
Postinflammatory hyperpigmentation (PIH) is usually the result of nodular acne lesions. These lesions often leave behind an inflamed darkened mark after the original acne lesion has resolved. This inflammation stimulates specialized pigment-producing skin cells (known as melanocytes) to produce more melanin pigment which leads to the skin's darkened appearance.[34] People with darker skin color are more frequently affected by this condition.[35] Pigmented scar is a common term used for PIH, but is misleading as it suggests the color change is permanent. Often, PIH can be prevented by avoiding any aggravation of the nodule, and can fade with time. However, untreated PIH can last for months, years, or even be permanent if deeper layers of skin are affected.[36] Even minimal skin exposure to the sun's ultraviolet rays can sustain hyperpigmentation.[34] Daily use of SPF 15 or higher sunscreen can minimize such a risk.[36]
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However, unlike the previously discussed treatment options, gender plays a role in how effective dapsone will be. Research has shown11 that female patients who use it get a much better response than male patients. It’s also a slow-working treatment. Studies among adolescents have shown that it is very effective, but it may take up to 12 weeks for improvements to show up, with more improvements taking place with continued use.

Considerations: Despite the frequent referencing of an initial flare of acne when starting is tretinoin, there is no scientific evidence to back this up. You should not expect an initial worsening of acne.3-4 Exposure to sunlight should be minimized as you may be more sensitive to its rays. Ask your doctor before using other medication on the skin, especially anything containing sulfur, resorcinol, or salicylic acid, as the combination may be too irritating. Abrasive soaps and cleansers should be used with caution for the same reason. Side effects can include skin irritation, swelling, lightening or darkening of the skin, an increase in acne sores, excessive redness, and crusted or blistered skin.


The other downside to Proactiv+ is that the bottles are small — like, half the size of Paula’s Choice small. Combine that with its recommended two or three-times daily application, and you’re going to be going through a lot of kits, which ultimately means spending more money on your treatment. If Proactiv is the only thing that works for you, it may very well be worth the investment, but we recommend starting with Paula’s Choice to see if you can get the same results at a cheaper price.
The Body Shop Tea Tree Oil Products: Even though it’s not made in a lab, tea tree oil has been studied and proven to be a powerful anti-acne agent. The Body Shop takes advantage of this ingredient with their full line of tea tree oil products, from pure oil to face wipes to a clay mask, all containing tea tree oil. These products are best for oily skin, pimples, and cystic acne.
Azelaic acid is a natural acid that is derived from various grains like wheat and barley. It helps reduce acne by preventing skin cell buildup, killing p. acnes bacteria, and reducing inflammation4. This means it can help reduce all kinds of acne, from blackheads to pimples. Blackheads and whiteheads form when dead skin cells combine with sebum, the oil our skin naturally produces and get clogged in a pore. To get rid of this kind of acne, it helps to regulate your skin cell production and exfoliate your skin to remove excess dead skin cells. Azelaic acid is a great way to do both of these things, while also decreasing inflammation and killing bacteria. When the skin is inflamed, it swells slightly, causing the pores to constrict. This traps dead skin cells and sebum inside, leading to blackheads and whiteheads, and if bacteria get trapped as well, then pimples can also form.
How to Handle It: If you've tried the usual anti-acne ingredients, like salicylic acid and benzoyl peroxide (which, we should warn you, rarely work for this), you should consider paying your dermatologist a visit. "You may need a cortisone injection or an oral medication, like an antibiotic, in addition to topical formulas," says Zeichner. He's also a fan of a prescription topical medication called Epiduo Forte Gel, since, he says, it's been shown to be effective at controlling severe acne without the help of oral treatments.
This type of skin can be oily and dry or oily and normal. Different places on your face will have different symptoms. The good news is that you probably won’t have acne on your cheeks since the skin there is usually less oily. You may have to use different treatments on different areas of your face, though. The T-Zone area of the forehead, nose and chin may be oilier, so exfoliating with a gentle cleanser each day should keep your facial skin balanced. You should look for a moisturizer that isn’t too heavy but that will hold in your skin’s moisture. Gel-like moisturizers are absorbed into combination skin quickly, but don’t over moisturize or your pores may become clogged. You may need to try several brands before finding one that works for you.
Thanks to its special MicroClear technology, Neutrogena Oil-Free Acne and Redness Facial Cleanser helps boost the delivery of active ingredient salicylic acid, in order to help reduce the appearance of acne. The inclusion of aloe and chamomile help to calm irritation while visibly reducing facial redness, a source of emotional stress for many acne sufferers.
Dr. Skotnicki recommends Bioderma Micellar Cleanser for acne. It’s one of the few products that can be used safely on both the face and body, even by people who are also taking acne medication. Its gentle formula won’t irritate skin, and it contains a patented “Fludiactiv” complex that helps regulate sebum quality to prevent pores from becoming clogged.
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]
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The idea behind using antibiotics for acne is that they can help reduce the number of p. acnes on the skin and relieve an acute case of severe acne. After the person stops taking the antibiotics, the hope is that the reduced numbers of p. acnes will prevent the pimples or cysts from getting out of hand again. However, in reality, most people simply end up taking the antibiotics much longer than they should, and the acne almost always comes back. That’s because, according to The Lancet: Infectious Diseases, over 50 percent of p. acnes strains are resistant to antibiotics7. If your doctor tries to prescribe you antibiotics for your acne, we recommend asking about other courses of action.


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]
No single product can contain all of the necessary acne-fighting ingredients, despite what some may claim. Some chemicals shouldn’t be used together, while others work together to totally eradicate acne and all the blemishes that come with it. The best acne treatment systems can do that for you, but because everyone’s skin is unique, what works for one person may not work for another. The key lies in finding the right system, a combination of products, that work best for your unique skin.
Antiandrogens such as cyproterone acetate and spironolactone have been used successfully to treat acne, especially in women with signs of excessive androgen production such as increased hairiness or skin production of sebum, or baldness.[10][46] Spironolactone is an effective treatment for acne in adult women, but unlike combined birth control pills, is not approved by the United States Food and Drug Administration for this purpose.[1][35][100] The medication is primarily used as an aldosterone antagonist and is thought to be a useful acne treatment due to its ability to additionally block the androgen receptor at higher doses.[35] Alone or in combination with a birth control pill, spironolactone has shown a 33 to 85% reduction in acne lesions in women.[91] The effectiveness of spironolactone for acne appears to be dose-dependent.[91] High-dose cyproterone acetate alone has been found to decrease symptoms of acne in women by 75 to 90% within 3 months.[101] It is usually combined with an estrogen to avoid menstrual irregularities and estrogen deficiency.[102] The medication has also been found to be effective in the treatment of acne in males, with one study finding that a high dosage reduced inflammatory acne lesions by 73%.[103][104] However, the side effects of cyproterone acetate in males, such as gynecomastia, sexual dysfunction, and decreased bone mineral density, make its use for acne in this sex impractical in most cases.[103][104][105] Hormonal therapies should not be used to treat acne during pregnancy or lactation as they have been associated with birth disorders such as hypospadias, and feminization of the male babies.[46] In addition, women who are sexually active and who can or may become pregnant should use an effective method of contraception to prevent pregnancy while taking an antiandrogen.[106] Antiandrogens are often combined with birth control pills for this reason, which can result in additive efficacy.[35][107]

The Daily Skin Clearing Treatment is an all-over 2.5 percent benzoyl peroxide cream that also touts calming bisabolol and allantoin to alleviate the dryness and irritation that can crop up mid-treatment. Anyone frustrated with oil-slick skin will also love this part of the regimen — it creates a satin mattifying effect, instantly transforming shininess into a glow.


Salicylic acid is a topically applied beta-hydroxy acid that stops bacteria from reproducing and has keratolytic properties.[132][133] It opens obstructed skin pores and promotes shedding of epithelial skin cells.[132] Salicylic acid is known to be less effective than retinoid therapy.[19] Dry skin is the most commonly seen side effect with topical application, though darkening of the skin has been observed in individuals with darker skin types.[1]
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