Mayo Clinic Health Library

Over-the-counter acne products: What works and why

Updated: 07-18-2012

Many over-the-counter (OTC) acne products are available to treat mild to moderate acne or periodic breakouts. But with so many acne products lining store shelves, how do you know which one is best for you?

Before you grab whatever package is closest, learn how OTC acne products work and what ingredients to look for. Then, develop a gentle skin care regimen to treat and prevent acne breakouts.

Active ingredients in acne products

Acne products work in different ways, depending on their active ingredient. Some OTC acne products work by killing the bacteria that cause acne inflammation. Other acne products remove excess oils from the skin or speed up the growth of new skin cells and the removal of dead skin cells. And in some cases, acne products work by doing a combination of these things.

Here are common active ingredients found in acne products and how they work to treat acne.

  • Benzoyl peroxide. Used in both OTC and prescription acne products, benzoyl peroxide kills the bacteria that cause acne, helps remove excess oils from the skin and removes dead skin cells that clog pores. Available in strengths from 2.5 to 10 percent, benzoyl peroxide can cause excessive dryness, scaling, redness, burning and stinging, especially if you have sensitive skin. Be careful when applying benzoyl peroxide, as it can bleach hair and clothing.
  • Salicylic acid. This ingredient slows shedding of cells inside the hair follicles, which prevents the pores from clogging. Salicylic acid can cause mild stinging and skin irritation. OTC acne products are available with 0.5 to 2 percent salicylic acid.
  • Alpha hydroxy acids. Glycolic acid and lactic acid are two types of alpha hydroxy acids that are used in OTC acne products. They're synthetic versions of acids derived from sugar-containing fruits. They treat acne by helping to remove dead skin cells and helping to reduce inflammation. Alpha hydroxy acids also stimulate the growth of new, smoother skin, which helps reduce the appearance of acne scars.
  • Sulfur. Often combined with other ingredients, such as salicylic acid, benzoyl peroxide or resorcinol, sulfur removes dead skin cells that clog pores and helps remove excess oil. Products containing sulfur may cause dry skin, and some products have an unpleasant odor.

Choosing an effective acne product

The acne product that's best for you depends on many factors, including your skin type, the type and severity of your acne, and your skin care preferences. Here are some general guidelines in choosing and using acne products:

  • Begin with benzoyl peroxide. If you're not sure which acne product to buy, start with one that contains benzoyl peroxide. It's effective and well tolerated by most people. Check product labels for the type and amount of its active ingredient. Stronger isn't always better with benzoyl peroxide. In some cases, a 2.5 percent product works as well as those with stronger concentrations — and with fewer side effects.
  • Start with lower strength acne products. This can help minimize redness, excessive dryness and other skin problems. If needed, gradually increase the strength and frequency of your applications over several weeks, so your skin can adjust to the treatments.
  • Use two products with different active ingredients to treat stubborn acne. Acne ingredients work in different ways, so you may find it helpful to use varying products and ingredients to treat stubborn acne. Apply one in the morning and the other at night to prevent skin irritation.
  • Be patient. Treating acne with acne products takes time and patience. It may take two or three months of daily use of an acne product to see results, and acne may look worse before it gets better.
  • Experiment with what works. You may need to try different products with varying active ingredients before you find a regimen that works for you.

Skin care tips when using acne products

Acne products are just one step in your skin care regimen. When using acne products:

  • Wash problem areas twice daily with a nonmedicated soap or mild cleanser. But don't overdo it. Excessive washing and scrubbing can worsen acne.
  • Apply just enough acne product to cover the problem areas and apply just after cleansing the skin.
  • Use an oil-free, water-based moisturizer to help alleviate dry, peeling skin in areas where needed.
  • Avoid oily cosmetics, sunscreens and hair products. Instead use products labeled "oil-free" or "noncomedogenic," which means they won't clog pores.
  • Don't pick or squeeze blemishes. Infection or scarring may result.
  • Watch what touches your face. Keep your hair clean and off your face. Also try to avoid resting your hand or your telephone against the side of your face.

If your acne doesn't improve after two or three months of treatment, consider seeing your doctor or a dermatologist for a prescription lotion or medication.