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]
In one 2018 meta-analysis published in the Journal of the European Academy of Dermatology and Venereolog, researchers found that milk consumption—particularly skim milk, which is higher in sugar than whole milk—was associated with a greater risk of acne. Beyond the higher sugar content, scientists believe that proteins and hormones found in milk products, including IGF-1, may play a role in acne flare-ups by increasing oil production and inflammation.

Feverfew – Commonly known as wild chamomile, feverfew is a plant that has been used for generations. It was once called “parthenium” by the ancient Greeks and is used to treat various ailments and disease. When it comes to your skin, feverfew is anti-inflammatory7, reducing and preventing redness and swelling. It’s also high in anti-oxidants and can be consumed orally in the form of tea for added benefits, like healing your skin from the inside out.
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.

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Scientists initially hypothesized that acne represented a disease of the skin's hair follicle, and occurred due to blockage of the pore by sebum. During the 1880s, bacteria were observed by microscopy in skin samples affected by acne and were regarded as the causal agents of comedones, sebum production, and ultimately acne.[163] During the mid-twentieth century, dermatologists realized that no single hypothesized factor (sebum, bacteria, or excess keratin) could completely explain the disease.[163] This led to the current understanding that acne could be explained by a sequence of related events, beginning with blockage of the skin follicle by excessive dead skin cells, followed by bacterial invasion of the hair follicle pore, changes in sebum production, and inflammation.[163]

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.
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.

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.
Hair follicles are the tiny structures that grow hair in the scalp. Sebaceous glands produce sebum. On areas where acne develops, sebaceous glands surround the hair follicles. The combination of the sebaceous glands and the hair follicles is the "pilosebaceous unit," where acne pimples and cysts develop. Sebum moisturizes hair and skin. Each hair pushes up through the skin surface along with sebum.

The costs and social impact of acne are substantial. In the United States, acne vulgaris is responsible for more than 5 million doctor visits and costs over US$2.5 billion each year in direct costs.[13] Similarly, acne vulgaris is responsible for 3.5 million doctor visits each year in the United Kingdom.[19] Sales for the top ten leading acne treatment brands in the US in 2015, have been reported as amounting to $352 million.[175]


The treatment regimen your doctor recommends depends on your age, the type and severity of your acne, and what you are willing to commit to. For example, you may need to wash and apply medications to the affected skin twice a day for several weeks. Often topical medications and drugs you take by mouth (oral medication) are used in combination. Pregnant women will not be able to use oral prescription medications for acne.
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]

People with problem skin and acne will need more time and effort to care for their skin. Just usual washing it with water, even if it is done regularly, is not enough. A standard beauty product, which can be used for healthy skin, isn’t suitable for problem skin care in this case. In the article you will learn what best face wash for acne on the face and prevent its reappearance.

Acne vulgaris Acne conglobata Acne miliaris necrotica Tropical acne Infantile acne/Neonatal acne Excoriated acne Acne fulminans Acne medicamentosa (e.g., steroid acne) Halogen acne Iododerma Bromoderma Chloracne Oil acne Tar acne Acne cosmetica Occupational acne Acne aestivalis Acne keloidalis nuchae Acne mechanica Acne with facial edema Pomade acne Acne necrotica Blackhead Lupus miliaris disseminatus faciei
In 2015, acne was estimated to affect 633 million people globally, making it the 8th most common disease worldwide.[9][17] Acne commonly occurs in adolescence and affects an estimated 80–90% of teenagers in the Western world.[18][19][20] Lower rates are reported in some rural societies.[20][21] Children and adults may also be affected before and after puberty.[22] Although acne becomes less common in adulthood, it persists in nearly half of affected people into their twenties and thirties and a smaller group continue to have difficulties into their forties.[2]
First, let’s talk about what causes acne. Pimples form when the oil and dead skin cells on your skin combine to form a plug that blocks the pores. “As the P. acnes bacteria that naturally live on skin overgrow within this plugged follicle, the area becomes inflamed and this is when you start to see papules, pustules, and cystic lesions,” RealSelf dermatologist Sejal Shah, M.D., tells SELF. The treatments ahead work to exfoliate away dead skin cells, suck up excess oil, stop inflammation, and kill the P. acnes bacteria. There are even a few treatments that target hormonal acne specifically.
“We’ve seen it work against a wide range of organisms, including 27 of the 32 strains of acne-causing bacteria,” says Michael Murray, ND, a naturopath and coauthor of The Encyclopedia of Natural Medicine. Multiple studies, including a review of research in the International Journal of Dermatology, back the plant’s power. You can find tea tree oil in a wide variety of soaps, skin washes, and topical solutions. Look for a minimum concentration of 5 percent of the oil to test how your skin reacts. If you find it is too irritating as an all-over treatment, you can use tea tree as a simple spot treatment for more stubborn pimples.
The best acne medication differs from person to person based on their skin care needs. For some, a gentle over-the-counter option is the best way to reduce acne, while for others, stronger prescription medication is necessary. Regardless of your acne needs, there is an acne medication available for you. The best way to find the right acne treatment is with patience, and sometimes with the assistance of a dermatologist. This guide will cover the basics of acne medication, from benzoyl peroxide to Accutane.
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]
Azelaic acid has been shown to be effective for mild to moderate acne when applied topically at a 20% concentration.[66][129] Treatment twice daily for six months is necessary, and is as effective as topical benzoyl peroxide 5%, isotretinoin 0.05%, and erythromycin 2%.[130] Azelaic acid is thought to be an effective acne treatment due to its ability to reduce skin cell accumulation in the follicle, and its antibacterial and anti-inflammatory properties.[66] It has a slight skin-lightening effect due to its ability to inhibit melanin synthesis, and is therefore useful in treating of individuals with acne who are also affected by postinflammatory hyperpigmentation.[1] Azelaic acid may cause skin irritation but is otherwise very safe.[131] It is less effective and more expensive than retinoids.[1]
A major mechanism of acne-related skin inflammation is mediated by P. acnes's ability to bind and activate a class of immune system receptors known as toll-like receptors (TLRs), especially TLR2 and TLR4.[44][64][65] Activation of TLR2 and TLR4 by P. acnes leads to increased secretion of IL-1α, IL-8, and TNF-α.[44] Release of these inflammatory signals attracts various immune cells to the hair follicle including neutrophils, macrophages, and Th1 cells.[44] IL-1α stimulates increased skin cell activity and reproduction, which in turn fuels comedo development.[44] Furthermore, sebaceous gland cells produce more antimicrobial peptides, such as HBD1 and HBD2, in response to binding of TLR2 and TLR4.[44]
However, salicylic acid isn’t just for those of us with sensitive skin. It can also help those of you with tougher skin, through higher concentrations. Over-the-counter, you can find salicylic acid in concentrations up to 2 percent, but if you want something even more intense, many spas and dermatology offices offer salicylic acid chemical peels with 20-30 percent salicylic acid. Beware, these peels will likely leave your face very photosensitive for a few days, but they have been known to significantly reduce sebum for a few weeks at a time.

Clean your face really well using a mild face cleanser and gently pat dry. Let your skin further air dry and don’t put anything else on it. Don’t put anything else on your face like moisturizer, serum, toner, etc. After a half hour, carefully check your cheeks, chin, forehead and nose, with a hand mirror, for any shine. Also, check if your skin feels tight when you smile or make exaggerated facial expressions.

We've already waxed poetic about the wonders of this brand's body sheet masks (one editor even wore hers topless!), which means we had high hopes for its citrus-scented cleanser. Luckily, it fulfilled its acne-fighting promises. Made with tea tree extract to target excess oil, salicylic acid to gently exfoliate skin cells, and niacinamide to smooth post-breakout texture, this formula targets every stage of a breakout.
Dapsone is a topical gel medicine sold under the brand name Aczone for treating severe acne, and it’s perfect for people who want a low-maintenance acne treatment plan. Unlike many of the best acne medications, dapsone only needs to be applied once daily, and it is the only medications most people will need, though it’s always good to include a face wash and moisturizer in your skin care routine if possible. Dapsone can function on its own because it is both antibacterial and anti-inflammatory10, effectively taking care of two of the biggest causes of acne.
Salicylic Acid – One of the most common topical ingredients you can find over-the-counter, salicylic acid is generally used to reduce the appearance of acne, by reducing swelling and redness. Also known as a beta-hydroxy acid, it exfoliates your skin4 and unclogs your pores, too, but it is quite strong. You’ll only be able to find this in strengths around 2%, but it can still dry and irritate your skin, especially if yours is sensitive. The safest way to use this ingredient is according to the directions!

The gel also contains benzoyl peroxide, which is essential for eliminating bacteria that provoke inflammation and redness of the skin. Apply a small amount of gel to cleansed skin and leave it on for a few minutes. After that, rinse with water. The number of applications should be from 1 to 3 times per day. The gel is well tolerated and can be used on all skin types, including sensitive.


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.
Azelaic acid has been shown to be effective for mild to moderate acne when applied topically at a 20% concentration.[66][129] Treatment twice daily for six months is necessary, and is as effective as topical benzoyl peroxide 5%, isotretinoin 0.05%, and erythromycin 2%.[130] Azelaic acid is thought to be an effective acne treatment due to its ability to reduce skin cell accumulation in the follicle, and its antibacterial and anti-inflammatory properties.[66] It has a slight skin-lightening effect due to its ability to inhibit melanin synthesis, and is therefore useful in treating of individuals with acne who are also affected by postinflammatory hyperpigmentation.[1] Azelaic acid may cause skin irritation but is otherwise very safe.[131] It is less effective and more expensive than retinoids.[1]
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