What it is: Originally under the brand name "Accutane" but now available only in generic form, isotretinoin is a derivative of vitamin A taken in pill form for 15-20 weeks. Doctors normally prescribe it for people with "severe nodular acne" that does not respond to other treatments. Nodules are inflammatory lesions with a diameter of 5mm or more. A single course of 15-20 weeks has been shown to result in complete clearing and long-term remission of acne in many people.1-2 Learn more on the Accutane page of acne.org.
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Oral antibiotics are recommended for no longer than three months as antibiotic courses exceeding this duration are associated with the development of antibiotic resistance and show no clear benefit over shorter courses.[87] Furthermore, if long-term oral antibiotics beyond three months are thought to be necessary, it is recommended that benzoyl peroxide and/or a retinoid be used at the same time to limit the risk of P. acnes developing antibiotic resistance.[87]
This top-of-line cleanser is one that really works amazingly for normal, combination and oily skin types. It’s a foaming face wash with 3% sulfur that makes your skin visibly clearer without drying it out. It removes blemishes, unclogs pores, draws out impurities all while calming redness and reducing excess sebum production. The sulfur in it helps to prevent future breakouts and tames even the worst acne breakouts.
You won't find a face wash in this list that's not universally beloved, but keep in mind that what works for one person won't work for everyone. The biggest secret to finding a great facial cleanser is choosing one that's formulated for your skin type: dry, oily, combination, sensitive or blemished. Unfortunately, few women really know their skin type.
Any acne treatment is a weeks-long experiment that you’re conducting with your skin. Acne is slow to heal, and in some cases, it can get worse before it gets better (nearly every benzoyl peroxide product we looked at emphasized the likeliness of irritating acne further, and starting off with a lighter application). April W. Armstrong, a doctor at the University of California Davis Health System, recommends waiting at least one month before you deem a product ineffective.
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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]
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Just as there are no bells and whistles with Purpose above, there are none with this baby-mild product that renowned dermatologists swear by. So why is this $10 cleanser such a must-have? It's creamy, simple and isn't loaded with chemicals or perfumes that can irritate the skin. Cetaphil products are revered in the industry and their cleanser is one of the best drugstore buys out there. Period.
Infused with salicylic acid from white willow bark and antioxidant-rich chamomile and gotu kola, this clarifying face wash is formulated for men and women of all skin types. It exfoliates and unclogs pores to boost cell turnover, soothes inflamed skin and counters free radical damage. Also works as a makeup remover and a deep-cleansing shaving cream!
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.

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.


If you have non-inflamed acne, it means you have a lot of blackheads and whiteheads, but not a lot of redness and swelling. Most common acne face washes can work well for you. If you have inflamed acne, you want to make sure you buy a facial cleanser that has the ingredients to reduce inflammation, swelling, and redness. But you also want to be careful not to buy or use anything that can cause irritation, dry skin and thus, more redness and swelling.

For years the French have have opted for super moisturizing cold creams. You simply massage this in and then wipe off with a tissue or a warm washcloth and you're left with super soft skin. It removes makeup without leaving skin feeling "tight." Plus, because you aren't using water to rinse the face, you might be saving your skin from the drying effects of water.
The best acne treatment system will include a cleanser, exfoliant and a treatment product that can be used daily. The idea is to have a product that cleans and clears clogged pores, kills bacteria, exfoliates to remove dead cells and spot treats trouble spots to combat stubborn blemishes and reduces inflammation and redness. For those with oily skin, a toner may be useful. For those with black heads, deep cleansing pore strips will help. If you have dry skin, foaming face wash would be something you want to avoid. The point is, a carefully tailored system is the best approach to an effective acne treatment.
Any acne treatment is a weeks-long experiment that you’re conducting with your skin. Acne is slow to heal, and in some cases, it can get worse before it gets better (nearly every benzoyl peroxide product we looked at emphasized the likeliness of irritating acne further, and starting off with a lighter application). April W. Armstrong, a doctor at the University of California Davis Health System, recommends waiting at least one month before you deem a product ineffective.
The Anti-Redness Exfoliating Solution is mostly water, but its 2 percent salicylic acid is enough to eat through oil and remove the dead skin cells clogging your pores — and it boasts a higher concentration than nearly every other kit we looked at. Sodium hyaluronate, the super-moisturizing humectant we fell in love with in our review on the Best Face Moisturizer, also caught our eye sitting smack dab in the middle of the ingredients list.
Benzoyl peroxide (BPO) is a first-line treatment for mild and moderate acne due to its effectiveness and mild side-effects (mainly skin irritation). In the skin follicle, benzoyl peroxide kills P. acnes by oxidizing its proteins through the formation of oxygen free radicals and benzoic acid. These free radicals are thought to interfere with the bacterium's metabolism and ability to make proteins.[79][80] Additionally, benzoyl peroxide is mildly effective at breaking down comedones and inhibiting inflammation.[78][80] Benzoyl peroxide may be paired with a topical antibiotic or retinoid such as benzoyl peroxide/clindamycin and benzoyl peroxide/adapalene, respectively.[35]
Both salicylic acid and benzoyl acid are commonly found in the top acne treatments for getting rid of mild to severe acne. They work in tandem to getting rid of the dead skin and killing bacteria, which are two of the main contributors to the spread of acne. Salicylic acid breaks up the skin to clear pores from skin, oil and bacteria and benzoyl peroxide kills the bacteria slowly over a 48-hour period.
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 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.

Warning: Sulfur smells like rotten eggs. But it is an effective ingredient at drying up pus-filled pimples and whiteheads (you’ve gotta take the good with the bad). It works by sucking up the oil. Sulfur is typically mixed with other active ingredients to get the most efficacy and fragrances to mask the strong scent. You can often find it in masks and spot treatments.

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A purifying gel cleanser made with 99.4% natural ingredients, this face wash is clinically proven to wash away excess oil, impurities and the bacteria that causes acne. It’s made with salicylic acid naturally derived from willow bark extract, evening primrose and beet root extracts that reduce acne, prevent future breakouts and calms acne prone skin. Best for oily skin types, this face wash helps to keep you oil-free without making your dry or irritated.


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.

Every expert we spoke with said the most critical part of combating acne is combating it every day. “The only way to make any medication work is to use it on a daily basis,” says Dr. Green. Fitz Patrick emphasizes that it really comes down to what you can maintain for the long term: “Kits are great because they take out all the guesswork -- you just follow the instructions. But if four steps is going to be too many for you to keep up week after week, you’ll be better off finding one that has fewer treatments.”
There are two big guns used to take down acne, and they're both great at doing entirely different things. Salicylic acid is a beta hydroxy acid that comes from willow bark and works primarily as an exfoliator, breaking down fatty acids like sebum so your pores don’t clog. (Glycolic acid works similarly but is less effective.) These acids do their thing on comedones — whiteheads, blackheads, and other non-red bumps.
The earliest pathologic change is the formation of a plug (a microcomedone), which is driven primarily by excessive growth, reproduction, and accumulation of skin cells in the hair follicle.[1] In normal skin, the skin cells that have died come up to the surface and exit the pore of the hair follicle.[10] However, increased production of oily sebum in those with acne causes the dead skin cells to stick together.[10] The accumulation of dead skin cell debris and oily sebum blocks the pore of the hair follicle, thus forming the microcomedone.[10] This is further exacerbated by the biofilm created by P. acnes within the hair follicle.[44] If the microcomedone is superficial within the hair follicle, the skin pigment melanin is exposed to air, resulting in its oxidation and dark appearance (known as a blackhead or open comedo).[1][10][19] In contrast, if the microcomedone occurs deep within the hair follicle, this causes the formation of a whitehead (known as a closed comedo).[1][10]
You’ve probably heard of the benefits of retinoid creams for anti-aging, but vitamin A is also efficient at clearing up acne. “[Retinoids] cause skin cells to turn over at a faster rate, decrease oil production, and help skin exfoliate,” board-certified dermatologist Rita Linkner, M.D., tells SELF. Another benefit: Acne is inflammation, and retinoids are anti-inflammatory.
A complete skin care regimen to control acne usually starts with washing. The ideal face wash creates a soft creamy lather in warm water. It rinses off dirt, excess oil, and makeup, leaving the face ready for the next step in daily skin care, whether that is toner, moisturizer, exfoliant, sunblock, or more makeup. It is fragrance-free, and it does not create a foam, film, or tingly sensation on the face. Any product that foams and suds vigorously, like a detergent, is a strict no-no for acne treatment, especially on dry skin.
“You unfortunately cannot determine the strength of a product strictly by the percentage of its active ingredients because how well a product works depends on how well its inactive ingredients help it penetrate the skin,” explains Dr. Green. “In other words, a 2 percent benzoyl peroxide may be more effective than another brand’s 5 percent benzoyl peroxide because there are other ingredients helping out.”
The alkaline ingredients in Ivory Soap reach into the skin and dissolve the fats and ceramides that lock moisture in and keep the skin soft and flexible. Tight skin constricts pores, locking oil and acne bacteria inside. If you wash your face with Ivory Soap once or twice a day, you almost certainly will have no big pieces of dirt or grime lurking in enlarged pores, but you are likely to have an ongoing problem with whiteheads and blackheads, and the constant irritation will also make pimples redder and more inflamed.
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.
Pimples are raised red spots with a white center that develop when blocked hair follicles become inflamed or infected with bacteria. Blockages and inflammation that develop deep inside hair follicles produce cystlike lumps beneath the surface of your skin. Other pores in your skin, which are the openings of the sweat glands, aren't usually involved in acne.
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]

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.


The acne companies that actually care about you, honest companies, offer a solid guarantee and honor it when necessary! A guarantee is a measure of the confidence a company has that their products will actually make a positive difference to your skin. Check Amazon and Google to see what people say about a company’s customer care before you buy. It’s the only way to know for sure what to expect before you buy from a certain company.
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.
If you have non-inflamed acne, it means you have a lot of blackheads and whiteheads, but not a lot of redness and swelling. Most common acne face washes can work well for you. If you have inflamed acne, you want to make sure you buy a facial cleanser that has the ingredients to reduce inflammation, swelling, and redness. But you also want to be careful not to buy or use anything that can cause irritation, dry skin and thus, more redness and swelling.

Antibiotics for acne, both topical and oral, used to be the top prescriptions for getting clear skin, but research has revealed that they aren’t the best option for most people today due to something called antibacterial resistance. This is where bacteria mutate, become immune to certain antibiotics, then reproduce offspring that are also immune, creating entire colonies of bacteria that can’t be killed by certain antibiotics.
A big acne myth is that you can wash it away. Although you should wash your face in the morning to rid it of any bacteria and saliva that might be lingering from your pillow, and you should wash it at night to clean away the sweat and grime that accumulated, twice a day is plenty. You also shouldn’t spend more than 30 seconds on this part of your skin care routine. Begin with warm water that is not too hot. When you are finished, you can splash your face with cold water to close the pores or use an astringent. Make sure you get a clean towel each time you wash so that you aren’t patting more bacteria onto your clean face. If you use a washcloth to clean your face, make sure you don’t reuse it.
Considerations: THERE IS AN EXTREMELY HIGH RISK THAT A DEFORMED INFANT CAN RESULT IF PREGNANCY OCCURS WHILE TAKING ACCUTANE IN ANY AMOUNT AND EVEN FOR SHORT PERIODS OF TIME. FEMALES WHO ARE PREGNANT OR WHO MAY BECOME PREGNANT WHILE UNDERGOING TREATMENT SHOULD NOT TAKE ACCUTANE. There are many other warnings as well.1-3 Side effects of Accutane are many, some of which include dry and cracked lips, dry skin, dry nose and mouth, mild to moderate muscle or joint aches.1-2,4-7
The Pore Normalizing Cleanser is designed just to cleanse, not treat, which is a good thing: The Nurse Practitioner study emphasizes the importance of washing with mild cleansers in conjunction with topical acne medications to combat or avoid excessive skin irritation. This one is water-based and fragrance-free, and uses sodium laureth sulfate (as opposed to its harsh cousin sodium lauryl sulfate) to eliminate any chance for irritation.
Globally, acne affects approximately 650 million people, or about 9.4% of the population, as of 2010.[157] It affects nearly 90% of people in Western societies during their teenage years, but can occur before adolescence and may persist into adulthood.[18][19][22] While acne that first develops between the ages of 21 and 25 is uncommon, it affects 54% of women and 40% of men older than 25 years of age,[46][158] and has a lifetime prevalence of 85%.[46] About 20% of those affected have moderate or severe cases.[2] It is slightly more common in females than males (9.8% versus 9.0%).[157] In those over 40 years old, 1% of males and 5% of females still have problems.[19]
I get asked all the time about my favorite organic skin care products. It seems everyone is worried about putting toxins in and on their bodies. So for cleansers, I recommend Dr. Hauschka's Cleansing Cream. Organic and void of chemicals, the Dr. Hauschka line is super popular among those concerned with healthy skin. So what's in this magic cleanser? Sweet almond meal and extracts of anthyllis, calendula, chamomile and St. John's wort. This cleanser gently exfoliates while adding moisture to skin, which makes it great for aging skin, dry skin and combination skin.
While you can certainly benefit from a great skin-care regimen, "in cystic acne, usually you need internal treatment," he says. "Topical medications usually don't work. Accutane is a great miracle cure for really bad cystic acne, but most people with cystic acne will improve with oral antibiotics — sometimes for two weeks, sometimes for three weeks."
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.
Hormonal treatments for acne such as combined birth control pills and antiandrogens may be considered a first-line therapy for acne under a number of circumstances, including when contraception is desired, when known or suspected hyperandrogenism is present, when acne occurs in adulthood, when acne flares premenstrually, and when symptoms of significant sebum production (seborrhea) are co-present.[128] Hormone therapy is effective for acne even in women with normal androgen levels.[128]
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.
You won't find a face wash in this list that's not universally beloved, but keep in mind that what works for one person won't work for everyone. The biggest secret to finding a great facial cleanser is choosing one that's formulated for your skin type: dry, oily, combination, sensitive or blemished. Unfortunately, few women really know their skin type.
Several scales exist to grade the severity of acne vulgaris, but no single technique has been universally accepted as the diagnostic standard.[68][69] Cook's acne grading scale uses photographs to grade severity from 0 to 8 (0 being the least severe and 8 being the most severe). This scale was the first to use a standardized photographic protocol to assess acne severity; since its creation in 1979, the scale has undergone several revisions.[69] The Leeds acne grading technique counts acne lesions on the face, back, and chest and categorizes them as inflammatory or non-inflammatory. Leeds scores range from 0 (least severe) to 10 (most severe) though modified scales have a maximum score of 12.[69][70] The Pillsbury acne grading scale simply classifies the severity of the acne from grade 1 (least severe) to grade 4 (most severe).[68][71]
To properly use sunscreen, you should put it on about 30 minutes before you plan to go outside. You will also need to reapply it if you sweat a lot. Be generous when you put it on and consider looking for a lip balm sunscreen specially made to protect your lips. Finally, make sure you are drinking enough fluid, so you don’t dehydrate your skin while outside.
What's Going On: If it's big, red, and painful, you're probably experiencing cystic acne, one of the more severe types. "Cystic pimples are caused by genetics and hormonal stimulation of oil glands," says Zeichner. Not only are they large, but they're also notoriously tough to treat. They often recur in the same place, because even if you manage to get rid of one, it can keep filling up with oil again and again, like an immortal pimple.
That’s why, no matter how uncomfortable your skin may feel while plagued with acne, you must resist the urge to touch your skin. If the irritating sensations become unbearable, there are other methods of treating your skin, such as cooling it with ice packs or aloe vera gel. You can even use medicated creams designed to soothe irritated skin – given that your dermatologist says it’s okay.
Perioral dermatitis Granulomatous perioral dermatitis Phymatous rosacea Rhinophyma Blepharophyma Gnathophyma Metophyma Otophyma Papulopustular rosacea Lupoid rosacea Erythrotelangiectatic rosacea Glandular rosacea Gram-negative rosacea Steroid rosacea Ocular rosacea Persistent edema of rosacea Rosacea conglobata variants Periorificial dermatitis Pyoderma faciale
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