Best acne treatments
The best acne treatments are rarely the strongest: low-strength benzoyl peroxide works as well as the 10% tubes, and your breakout type matters more than the percent. Deep cysts and stubborn jawline flares are where prescriptions come in.
Over-the-counter adapalene (a retinoid), benzoyl peroxide, salicylic acid and azelaic acid are where the best acne treatments start for blackheads, red pimples and dark spots; cystic or hormonal acne that won't clear needs a prescription.
- OTC: mild to moderate
- Prescription: moderate to severe
- Strength for each
- Pregnancy notes
Last reviewed · Checked against the AAD, NIH sources and clinical trials
| Treatment | What it does | Best for | Strength | OTC or Rx | Time to results | Pregnancy | Example product |
|---|---|---|---|---|---|---|---|
| Benzoyl peroxide | Kills acne bacteria, clears excess oil and dead skin cells | Red pimples, mild to moderate acne | 2.5% to 10% | OTC | 2 to 3 months | Ask your doctor first | CeraVe Acne Foaming Cream Cleanser (4%), PanOxyl Acne Foaming Wash (10%) |
| Adapalene 0.1% | Retinoid that unclogs pores and stops new breakouts | Blackheads, whiteheads, some pimples | 0.1% | OTC | 2 to 3 months | Avoid (topical retinoid) | Differin Gel (adapalene 0.1%) |
| Salicylic acid | Opens clogged pores and exfoliates | Whiteheads and pimples | 0.5% to 2% | OTC | 2 to 3 months | Ask your doctor first | CeraVe Acne Control Cleanser (2%) |
| Azelaic acid | Keeps pores open, mildly antibacterial, fades dark spots | Acne that leaves dark spots | 10% OTC, 20% Rx | OTC or Rx | 2 to 3 months | Rx azelaic acid is an option | The Ordinary Azelaic Acid Suspension 10% |
| Tretinoin | Prescription retinoid that stops pores plugging | Blackheads, whiteheads, moderate acne | Set by your doctor | Rx cream or gel | 4 to 8 weeks | Avoid (topical retinoid) | |
| Clascoterone | Cream that treats the hormonal causes of acne | Moderate to severe acne, males and females 12+ | 1% cream | Rx cream | 4 to 8 weeks | Ask your doctor first | |
| Topical clindamycin with benzoyl peroxide | Antibiotic and benzoyl peroxide in one, with less risk of resistance | Mild to moderate red acne | 1% clindamycin + 5% BP, or 1.2% + 2.5% | Rx gel | 4 to 8 weeks | Ask your doctor first | |
| Oral antibiotics (doxycycline) | Pill that cuts bacteria and inflammation, for the shortest time | Moderate to severe pimples, not nodules | Set by your doctor | Rx pill | 4 to 8 weeks | No tetracyclines; ask about a macrolide | |
| Spironolactone | Blocks androgen hormones at the oil glands | Women with stubborn chin and jawline acne | Set by your doctor | Rx pill, women only | 4 to 8 weeks | Never: can cause severe birth defects | |
| Combined birth control pill | Estrogen and progestin pill; some are FDA-approved for acne | Women whose acne flares with their period | Set by your doctor | Rx pill, women only | A few months | Tell your doctor if pregnant or planning to be | |
| Isotretinoin | Oral retinoid that shrinks the oil glands | Severe nodular acne other treatments didn't clear | Set by your doctor | Rx pill, FDA risk program | 4 to 8 weeks | Never: severe birth defects |
Time to results: over-the-counter products 2 to 3 months of daily use; most prescription acne drugs 4 to 8 weeks; the pill 2 to 3 months (AAD). Pregnancy: AAD. Example products: ingredient and strength checked on each brand's own product page; not endorsements. Prescription doses are your doctor's call.
How to choose an acne treatment
Choosing an acne treatment is matching an active ingredient to the kind of breakout you have. It means your acne type, not the brand, decides the pick, and our guide to acne types and how to treat each one shows how to tell them apart. The strength of the product matters less than you'd think: lower-strength benzoyl peroxide works as well as higher strengths.
- Match the ingredient to the acne type. Blackheads and whiteheads: a retinoid such as adapalene, or salicylic acid. Red pimples: benzoyl peroxide. Dark spots after acne: azelaic acid.
- Start with one product. If you're unsure, start with benzoyl peroxide, adapalene or both, at a lower strength.
- Give it 6 to 8 weeks. That's how long it takes to see fewer breakouts. Acne may get worse before it gets better.
- Add a second only if needed. For stubborn acne, use two different active ingredients, one in the morning and one at night.
- See a doctor for cysts or scarring. Also when nothing has helped after 2 to 3 months.
Best acne treatments over the counter
Over-the-counter (OTC) acne treatments are products you can buy without a prescription. They mean mild to moderate acne can be treated at home, and a good acne treatment at home uses just one or two of the four below. The strength of each ingredient is printed on the label as a percentage.
- Benzoyl Peroxide
- Kills acne-causing bacteria and removes excess oil and dead skin cells. Sold from 2.5% to 10%; lower strengths work as well as higher ones. It can bleach hair and fabric and sting sensitive skin.
- Topical Retinoids (Adapalene 0.1%)
- Adapalene is a retinoid that unclogs pores and prevents new breakouts, sold without a prescription at 0.1%. Use it in the evening and protect your skin from the sun. Skip skin that is cut, sunburned or has eczema.
- Salicylic Acid (0.5%–2%)
- Opens clogged pores and exfoliates, which helps whiteheads and pimples. It comes as leave-on and wash-off products. Studies of how well it works are limited.
- Azelaic Acid (10%)
- Helps keep pores from plugging, is mildly antibacterial and fades the dark spots acne leaves behind. A 20% prescription cream or gel also exists.
Best acne treatments by prescription
Prescription acne treatment is medicine a doctor prescribes when over-the-counter products haven't worked after several weeks. It means stronger options for moderate to severe acne. The choice of prescription depends on your age, your acne type and its severity.
- Prescription Retinoids
- Tretinoin, tazarotene and trifarotene keep pores from plugging. They raise sun sensitivity and can dry and redden skin, especially brown or Black skin. Don't apply tretinoin at the same time as benzoyl peroxide.
- Topical Combinations
- Clindamycin paired with benzoyl peroxide lowers the risk of antibiotic resistance; a topical antibiotic alone isn't recommended. Clascoterone 1% cream treats the hormonal causes of acne in males and females aged 12 and up.
- Oral Medications
- Doxycycline and other antibiotics treat moderate to severe pimples for the shortest time, together with benzoyl peroxide. Spironolactone (women only) and the combined birth control pill target hormones; both are used for hormonal acne treatment. Isotretinoin is for severe nodular acne that hasn't responded to anything else and needs an FDA risk program.
Ask your doctor about any of these. Online acne treatment is another way to get a prescription.
Pimple patches and spot treatments
A pimple patch (hydrocolloid dressing) is a small sticky pad you put over a single spot. It means the spot is covered, so it's easier to leave alone. The limit of any spot treatment is that it reaches one pimple, not the pores around it.
Picking or squeezing raises the risk of infection and scarring. Retinoids are not spot treatments: they go on the whole area to stop new pimples forming.
General guidelines
General acne care is the daily routine that keeps even the best acne treatments working. It means gentle skin care while the active ingredient does its job. The success of treatment depends on sticking with it.
- Be patient
- Allow at least 6 to 8 weeks to see fewer breakouts, and 2 to 3 months for over-the-counter products.
- Avoid irritation
- Wash twice a day with a mild cleanser, warm water and your hands. Skip scrubs, astringents and masks. Choose noncomedogenic products and a nonoily moisturizer with sunscreen. Don't pick or squeeze.
Thinking of adding zinc or fish oil? This look at acne supplements and their trials finds only zinc has a pooled analysis behind it, so treat a supplement as an add-on to skin care, not a swap.
Reader questions
Short, plain answers to what people ask most.
What is the #1 best acne treatment?
Honestly, there isn't one. The AAD says the best treatment for one person isn't necessarily the best for another. If you just want a starting point, benzoyl peroxide, adapalene, or both are the usual first picks.
What is the most effective acne drug?
It depends on the acne. For severe nodular acne that nothing else has cleared, dermatologists prescribe isotretinoin. It's strong stuff: it needs an FDA risk program and can't be taken in pregnancy. For most acne, combining medicines, like a retinoid with benzoyl peroxide, makes each one work better.
What is the most effective product for treating acne?
Look at the active ingredient, not the brand. Benzoyl peroxide and adapalene are the usual two to start with, and dermatologists often prescribe them together in one gel. Give whatever you pick 2 to 3 months.
What kills acne naturally?
Tea tree oil comes up a lot. In one trial, a 5% tea tree oil gel worked about as well as 5% benzoyl peroxide lotion, just slower, and some people get redness or irritation from it. Azelaic acid is natural too; it's found in grains like barley, wheat and rye.
What foods trigger acne?
Some studies link skim milk, whey protein and high-sugar diets to acne. Chocolate isn't directly linked. A balanced diet with plenty of fruit and vegetables is the safe bet.
Sources
- American Academy of Dermatology: Acne diagnosis and treatment
- American Academy of Dermatology: When acne won't clear
- Tea tree oil versus benzoyl peroxide trial (Med J Aust, 1990), PMID 2145499
- NCCIH: Tea tree oil
- American Academy of Dermatology: Acne treatment during pregnancy
- American Academy of Dermatology: Hormonal therapy for acne
Last reviewed .
This page is general information, not a diagnosis. See a dermatologist if you have deep cysts or nodules, scarring, over-the-counter products haven't helped after 2 to 3 months, or you're pregnant and want treatment.