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“The majority of acne I see in my practice in women in their 20s, 30s, and 40s is hormonal,” says Meera Sivendran, MD, assistant professor of dermatology at Mount Sinai in New York. These hormonal shifts, such as getting your period, getting pregnant, entering perimenopause, (the transition period before menopause when ovaries gradually make less estrogen), and then menopause increase oil production, says Eric Meinhardt, MD, founder and medical director of California Dermatology Specialists.
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.
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 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.
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.
Considerations: Because tazarotene is a retinoid (vitamin A derivative), like Accutane, it should not be used by women who are pregnant because of potential harm to the fetus. Exposure to sunlight should be avoided. Wind or cold may be more irritating when taking tazarotene. Side effects occured in 10-30% of patients and included dry peeling skin, burning, stinging, dry skin, redness, and itchiness.
First, it’s a cleansing oil, not the typical gel wash or liquid. Next, it has a potent blend of salicylic, glycolic, and lactic acid for superior exfoliation. Third, it contains natural ingredients that repair damage to the skin and get rid of acne. For example, soapwort extract dissolves oil without the need for drying sulfates. Then, vitamin B and lavender combine to reduce oil secretion and inflammation. Finally, watercress is full of antioxidant vitamins that heal damage caused by the sun.
Customers say yes, their skin feels soft and clean after they wash with it. Moreover, it’s packed with natural remedies like tea tree, neem, and holy basil oils. Tea tree kills acne bacteria and heals inflammation. Neem oil is also anti-inflammatory and antiseptic, plus it strengthens the skin against environmental pollution. Then, holy basil oil detoxifies and acts as a toner.
A review published in the Archives of Dermatological Research found evidence that sleep deprivation, stress and other aspects of “modern life” are linked to adult female acne. The researchers point out that “Modern life presents many stresses including urban noises, socioeconomic pressures and light stimuli. Women are especially affected by stress during daily routine. Women also have a higher risk of developing psychiatric disorders such as depression and anxiety. Sleep restriction is added to these factors, with several negative consequences on health, including on hormonal secretion and the immune system.” (7)
Tretinoin: As we said above, tretinoin (common brand name: Retin-A) is a synthetic retinoid, but it is stronger than some of the other options, and its cousin, isotretinoin, is even stronger. Isotretinoin, better known as Accutane, is an oral synthetic retinoid typically only prescribed for very severe cases of cystic acne because it can cause intense side effects and is a powerful teratogen, meaning it causes birth defects. However, after taking isotretinoin for several months, many people never need to do any serious acne treatment again, so for some, it is well worth the side effects.
Spot treatments are designed to give problem pimples a mega-dose of concentrated benzoyl peroxide — in a couple of regimens, like the Proactiv Teen Kit, the spot treatment had nearly three times the benzoyl peroxide as its all-over treatment. The logic: If benzoyl peroxide can be irritating to the skin in high concentrations, limiting its intensity to just the pimple itself could save the rest of your healthy skin.
You’d be hard-pressed to find a derm who won’t tell you to run to the drugstore to pick up this retinoid, the only one available OTC. A retinoid (a vitamin A derivative that speeds cell turnover) can treat acne by exfoliating the skin to prevent clogged pores, says Dr. Meinhardt, who recommends Differin to patients. Use a few times per week and then build up to nightly use, he says. (Once you’ve got control of your acne, check out these OTC retinol products for a complete skin overhaul. They’ll ban blemishes, reduce wrinkles, and combat aging.)
Genetics play a big part in who gets acne and how severely, but each blemish can be blamed on some combination of sebum production, a bacteria called Propionibacterium acnes (P. acnes), plugged follicles, and inflammation. Finding a good treatment is really about finding the right combination of ingredients to troubleshoot each of those issues. Some factors that might worsen acne include hormones, certain medications, diet and stress.
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.
Low concentrations of salicylic acid, like 0.5 percent, are perfect for people who have both acne and sensitive skin. If you have sensitive skin, you know that most of the “best” acne medications just don’t work for you because they are too strong. Products that are too strong for you can cause increased inflammation, which can actually lead to more acne rather than less. Because of this, salicylic acid is our number one recommendation for sensitive skin.
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.”
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.
PanOxyl Acne Foaming Wash: This product is marketed for facial acne, but we recommend using on pesky body acne instead. PanOxyl uses benzoyl peroxide, a highly effective acne-fighting ingredient that we’ll describe more just below, but at a concentration that is much too high to be used on your face. Most PanOxyl products contain 10% benzoyl peroxide, which will likely cause peeling and burning on your face, but could be the perfect solution for back or butt acne.
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.
If you’ve ever suffered from acne in the past, then you’re probably wondering how to get rid of acne scars that can remain for months or even years. Treating acne scars takes patience and perseverance. The sooner you start treating a scar, the better possible results. The vast majority of individuals who get acne will experience some degree of scarring. The most important thing you can do to prevent scarring? During a breakout, never pick or pop pimples, whiteheads or blackheads!
Acne vulgaris is the catch-all term for everything from angry red lesions to tiny white bumps, which are the results of hair follicles and their sebaceous glands becoming blocked and inflamed So our first plan was to look at it all — spot treatments, washes, scrubs and creams — until we learned that when it comes to over-the-counter treatments, there is no single cure.

Be patient: This is one of the most important steps when getting rid of your acne (aside from never, ever popping a pimple with your hands, which will only make the infection go deeper into your skin and cause scarring). “Treating acne over-the-counter can be a somewhat slow process. You can expect to notice improvements in four to six weeks,” says Dr. Sivendran. Keep in mind it’s possible that skin will look worse before it looks better, so give your current regimen one to two months before moving on to new products.
Ask any dermatologist for advice on how you can reduce the chances of breakouts, and they’re most likely going to mention taking probiotics as one of their top tips. This facial cleanser, infused with tea tree oil, willow bark and yogurt, targets irritation-causing bacteria while controlling oil production. It also features a biocomplex of vitamins A, C and E, coenzyme Q10 and antioxidants that diminish wrinkles and other visible signs of aging.
Oral isotretinoin is very effective. But because of its potential side effects, doctors need to closely monitor anyone they treat with this drug. Potential side effects include ulcerative colitis, an increased risk of depression and suicide, and severe birth defects. In fact, isotretinoin carries such serious risk of side effects that all people receiving isotretinoin must participate in a Food and Drug Administration-approved risk management program.
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