There are 3 OTC drugs for acne that all work about as well as each other: benzoyl peroxide, azlaic acid, and adapalene. It's best to use them in conjunction with each other. Studies have shown 2.5% benzoyl peroxide works just as well as 5% or 10% with less irritation. Azlaic acid is non-exfoliating and non-irritating and mainly kills acne bacteria. OTC azleic acid is 10% in the US but 15-20% is OTC in other countries you can order from, notably Australia. Adapalene is a retinoid, 0.1% concentration is available OTC but you can get 0.3% via prescription.
Hydrocolloid patches:
Once acne forms, instead of popping the pimple you can put one of these patches over it overnight and it will suck the pus out of it without leaving a scar. There are patches with microdarts as well. They work very well.
Bonus topicals:
Salicylic acid- unlike other acids is oil soluble and deeply unclogs clogged pores, maximum concentration OTC is 2% so look for a product that says 2%. It self neutralizes in about 3 minutes so using a 2% SA cleanser/wash, keeping it on for 3 minutes and washing it off is sufficient.
Niacinamide- reduces oil production, it also has moisturizing and anti-redness properties. The Ordinary has a 10% serum.
Retinoids:
Retinoids like adapalene, retin-a and tazarotene will cause your skin you get worse for about 4-6 weeks before getting better. The second week is the worst. Adapalene has advantages that it penetrates deeper than the others, is less irritating than the others, and light doesn't break it down so you can put it on in daytime unlike retin-a. You can also use benzoyl peroxide with it unlike retin-a.
Oral accutane/isotretinoin is an isomer of retin-a/tretinoin with similar properties only taken oral. The side effects (joint/muscle soreness, chapped lips, hair loss, eye/skin photosensitivity, liver damage, depression) are so severe that the company that developed it no longer makes it because of the lawsuits. But it is available as a generic drug and sometimes is the only thing that works. It's main advantage is it works permanently in most people. But don't reach for an oral drug if topicals will work instead.
You will need to use a moisturizer and sunscreen with retinoids
Peels:
A dematologist or esthician can do a 10-30% salicylic acid peel or a 1%-5% retinoic acid (aka retin-a/tretinoin) peel. A variety of other peels are available too but these work best for acne. They cost about $200-300 and are done about once a month. You may need to stay home for a few days afterwards due to the chemical burning your face and healing from that.
There are milder peels like The Ordinary's 30% AHA/BHA peel you can get OTC for $8 and are safe to do yourself once a month. You should not experience burning.
Time:
It takes 3 months for new skin cells to reach the top of your skin. So deep acne might take a month or two to surface and likewise any intervention you make with your skin you might not see a difference for a few months. A peel is the exception though, it works quickly.
Hydrocolloid patches:
Once acne forms, instead of popping the pimple you can put one of these patches over it overnight and it will suck the pus out of it without leaving a scar. There are patches with microdarts as well. They work very well.
Bonus topicals:
Salicylic acid- unlike other acids is oil soluble and deeply unclogs clogged pores, maximum concentration OTC is 2% so look for a product that says 2%. It self neutralizes in about 3 minutes so using a 2% SA cleanser/wash, keeping it on for 3 minutes and washing it off is sufficient.
Niacinamide- reduces oil production, it also has moisturizing and anti-redness properties. The Ordinary has a 10% serum.
Retinoids:
Retinoids like adapalene, retin-a and tazarotene will cause your skin you get worse for about 4-6 weeks before getting better. The second week is the worst. Adapalene has advantages that it penetrates deeper than the others, is less irritating than the others, and light doesn't break it down so you can put it on in daytime unlike retin-a. You can also use benzoyl peroxide with it unlike retin-a.
Oral accutane/isotretinoin is an isomer of retin-a/tretinoin with similar properties only taken oral. The side effects (joint/muscle soreness, chapped lips, hair loss, eye/skin photosensitivity, liver damage, depression) are so severe that the company that developed it no longer makes it because of the lawsuits. But it is available as a generic drug and sometimes is the only thing that works. It's main advantage is it works permanently in most people. But don't reach for an oral drug if topicals will work instead.
You will need to use a moisturizer and sunscreen with retinoids
Peels:
A dematologist or esthician can do a 10-30% salicylic acid peel or a 1%-5% retinoic acid (aka retin-a/tretinoin) peel. A variety of other peels are available too but these work best for acne. They cost about $200-300 and are done about once a month. You may need to stay home for a few days afterwards due to the chemical burning your face and healing from that.
There are milder peels like The Ordinary's 30% AHA/BHA peel you can get OTC for $8 and are safe to do yourself once a month. You should not experience burning.
Time:
It takes 3 months for new skin cells to reach the top of your skin. So deep acne might take a month or two to surface and likewise any intervention you make with your skin you might not see a difference for a few months. A peel is the exception though, it works quickly.
