Antibiotics. These work by killing excess skin bacteria and reducing redness. For the first few months of treatment, you may use both a retinoid and an antibiotic, with the antibiotic applied in the morning and the retinoid in the evening. The antibiotics are often combined with benzoyl peroxide to reduce the likelihood of developing antibiotic resistance. Examples include clindamycin with benzoyl peroxide (Benzaclin, Duac, Acanya) and erythromycin with benzoyl peroxide (Benzamycin). Topical antibiotics alone aren't recommended.
This spot treatment is packed with 2 percent salicylic acid to reduce redness and help clear gunk from pores. While derms recommend it to their patients, also know that is has more than 1,000 reviews on Amazon with a 4-star rating, mainly because it gets the job done across combination skin types. (This product also made BestProducts.com's list of the 10 best acne treatments.)
While a few people suffer from acne that is so severe it requires a medical prescription from a doctor, most people with mild to medium acne problems can find decent over-the-counter treatments that really work. The first key to getting your acne cleanser right is to know what active ingredients combat your acne, and then finding an acne treatment that contains it. Here are a few of the ingredients you want to look for:
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.
Although there is no one single cure for acne, we based our reviews first on what doctors are saying about these products and their ingredients. Then we did some digging into all the reviews. We ruled out those products that had primarily negative responses. After all that, we consulted natural product experts to see which system they felt were the best acne treatment.
Considerations: Regardless of the type of antibiotic prescribed, only about one half of patients respond. When antibiotics do produce results, these results are moderate at best.5-8 Oral antibiotics should be used for only a short period of time, up to 6 months. However, even within this short time frame, antibiotics have been implicated in the proliferation of resistant colonies of bacteria. Some antibiotics cause increased sensitivity to sunlight. Exposure to the sun could cause a rash, itchiness, or redness, and you may be burnt more easily, so you'll want to wear protective clothing and sunscreen.2 Side effects may include upset stomach, diarrhea, nausea, headache, vomiting, dizziness, or light-headedness as your body becomes accustomed to it.2 Minocycline is less prescribed because it works no better than any other antibiotic and comes with safety concerns, including the possibility of irreversible skin pigmentation.8-11
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.
Most studies of acne drugs have involved people 12 years of age or older. Increasingly, younger children are getting acne as well. In one study of 365 girls ages 9 to 10, 78 percent of them had acne lesions. If your child has acne, consider consulting a pediatric dermatologist. Ask about drugs to avoid in children, appropriate doses, drug interactions, side effects, and how treatment may affect a child's growth and development.