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Over-the-Counter Acne Medication: A Pharmacist Explains The Top 8 Options

Acne vulgaris is the most common chronic skin condition in the world, affecting 85% of people between ages 12 and 24. It's characterized by pimples (skin lesions) on the face, chest, or back.

Finding effective acne treatments can be tricky, but it is crucial. For some people, acne may cause permanent scarring, along with mental health issues like anxiety, depression, and low self-esteem.

Over-the-counter (OTC) acne medications are accessible options for managing acne. Many people try them before or instead of consulting a healthcare provider.

Nadija Pavlovic / Getty Images

Types of OTC Acne Medications OTC acne products include lotions, creams, gels, scrubs, cleansers, and more. In some cases, OTC acne medications may be all you need to manage mild or moderate acne. If your acne is more severe, OTC medicines may help enhance the effects of prescription treatments. Here's what you need to know about the active ingredients you'll find on the pharmacy shelf. 1. Benzoyl Peroxide Benzoyl peroxide is the most commonly recommended OTC acne medication in the U.S. People have been using it to treat acne for almost a century. Description: Benzoyl peroxide is a topical (applied to the skin) antibiotic. OTC concentrations range from 2.5% to 10%. It's available in lotions, creams, gels, foams, solutions, and cleansing bars. Benzoyl peroxide is applied to clean skin once or twice a day. It's effective by itself or when combined with other medicines, particularly antibiotics. Benefits: It is antibacterial, attacking the bacteria Cutibacterium acnes, a primary cause of acne. Examples: Products like Neutrogena On-the-Spot Acne Treatment, PanOxyl Acne Creamy Wash, Differin Daily Deep Cleanser, Acne Free Severe Acne Deep Cleansing Foaming Wash Considerations: It may cause skin redness, peeling, or burning, and it can bleach clothes or hair. Start with lower concentrations, which may be as effective as higher concentrations for mild or moderate acne. 2. Salicylic Acid Salicylic acid is another popular OTC acne treatment. At high concentrations, you can also use it for cosmetic chemical peels. Description: Salicylic acid is a topical medicine that helps promote skin peeling (exfoliation). It's available OTC in concentrations of 0.5% to 5% for acne. Benefits: It helps dead skin peel and reduces sebum production (oil). Examples: Products like CeraVe Acne Control Gel, PanOxyl Clarifying Exfoliant, Neutrogena Oil-Free Acne Wash, and the Ordinary Salicylic Acid 2% Solution Considerations: It may cause skin irritation or peeling. 3. Alpha Hydroxy Acids (AHAs) Alpha hydroxy acids (AHAs) include the following organic acids found in nature: glycolic, citric, lactic, and malic acid. People who cannot use first-line treatments due to side effects or other reasons may use AHAs. Description: AHAs are used for skin peeling in conditions like acne, scarring, and age spots. Benefits: AHAs hydrate skin, exfoliate, and decrease acne lesions. Examples: Products like Cerave Skin Renewing Nightly Exfoliating Treatment, The Ordinary Glycolic Acid 7% Toning Solution, and L'Oreal Paris Revitalift 10% Pure Glycolic Acid Considerations: They may cause redness, swelling, itching, or burning; start with low concentrations. 4. Sulfur Sulfur is a chemical element. It was a common ingredient in acne medications in the past but not so much anymore. Description: Sulfur is a topical medication that can help prevent clogged pores and is effective for mild to moderate acne alone or in combination. Benefits: It helps dry the skin and has antibacterial properties. Examples: Products like ProActiv Skin Purifying Mask, Face Reality Sulfur Spot Treatment, and Thayers Rapid Acne Treatment Considerations: It may be less popular due to its strong odor. It's often used in combination products to hide the scent. 5. Tea Tree Oil Tea tree oil is an essential oil traditionally used for bug bites, wounds, athlete's foot, and acne. Description: Oil from the Melaleuca alternifolia plant is a popular herbal remedy available as an OTC acne treatment in formulations like gels and face washes. Benefits: It has anti-inflammatory and antibiotic effects. It helps with oily skin and decreases pimples. Examples: Products like Burt's Bees Herbal Blemish Stick, MeridaSkin Tea Tree Oil Foaming Facial Cleanser, and The Beauty Foundry Clarifying Tea Tree Facial Oil Considerations: It may cause allergic reactions, itching, or scaly skin. It is for use only on the skin and is toxic if taken by mouth. Avoid high concentrations if you have broken skin. 6. Retinoids Retinoids are products derived from vitamin A. They are the most effective medicines for managing mild to moderate acne. Most retinoids for acne require a prescription (brand names include Retin-A, Tazorac, and Claravis). Adapalene, 0.1% gel, is the only retinoid available OTC. Description: This first-line treatment for acne is applied to clean skin once daily after the first few weeks. Benefits: It has anti-inflammatory effects. It reduces acne lesions and prevents new breakouts. It may improve scarring and lighten skin. Examples: Products like Differin Gel Acne Treatment and ProactivMD Adapalene Gel 0.1% Considerations: It may cause redness, peeling, dry skin, or burning. Most irritation occurs within the first two weeks of use. To minimize side effects, gradually increase how often you apply it. Also, you should apply sunscreen regularly when using retinoids due to the risk of sun sensitivity. 7. Azelaic Acid Azelaic acid occurs naturally in barley and grain. It helps block bacteria that cause acne. Description: Azelaic acid is a topical medicine that manages acne and brightens scarred skin. Benefits: It has antibacterial, antioxidant, and anti-inflammatory effects. Examples: Products like Paula's Choice Azelaic Acid Booster, Dermatica Clarifying Azelaic Acid Cream, and The Ordinary Azelaic Acid Suspension Brightening Cream. Considerations: It may cause skin irritation, including redness, burning, or stinging. It can also cause more highly pigmented skin to lighten. 8. Witch Hazel Witch hazel is a liquid extracted from the Hamamelis virginiana plant, native to North America. It helps reduce bacteria on the skin and may reduce inflammation. Description: Witch hazel is a topical medicine used to manage acne. Benefits: It has antimicrobial and anti-inflammatory effects. Examples: Products like Thayers Rose Petal Witch Hazel Facial Toner with Aloe Vera, Dickinson's Witch Hazel Toner, Burt's Bees Witch Hazel and Aloe Soothing Toner, and T.N. Dickinson's Witch Hazel Soothing MultiUse Cleansing Cloth. Considerations: It may cause skin irritation or an allergic reaction. How to Choose the Right OTC Acne Medication When striving to manage acne successfully with OTC acne medication, it's essential to evaluate your options carefully. Several factors to consider when choosing a treatment include the following: Acne type: Different products are more suitable for some types of acne than others. Retinoids are generally the most effective first treatment for whiteheads or blackheads. For inflammatory acne, consider adding benzoyl peroxide to a retinoid. Azelaic acid is a good choice if you have acne scarring. Skin type: Select products based on your skin type (oily, dry, combination, sensitive). People with dry skin will typically respond well to creams and lotions. Those with oily skin may be better off using a gel. People with sensitive skin must proceed extra slowly when starting retinoid treatment because these can irritate the skin. Ingredients: Read the ingredients list to ensure it does not contain ingredients to which you're allergic. Choose a medication based on its effectiveness and consider its potential for irritation. Ask your pharmacist for recommendations if you cannot see your healthcare provider. Test it out: To ensure your chosen product suits your skin well, first test it on a small area. Dermatologists recommend applying a small amount of the medicine to the same spot of your skin for seven to 10 days to monitor for skin reactions. When choosing the right OTC acne medication, also consider your preferences, such as fragrant versus fragrance-free brands. How to Use OTC Acne Medications Before starting any OTC acne treatment, understanding how to use these products effectively is essential. To optimize results, follow these recommendations when using OTC acne products: Instructions: Follow the manufacturer's directions unless your healthcare provider suggests otherwise. Ask your healthcare provider or pharmacist if specific tips can help you achieve results and minimize the side effects of your medicine. For example: If you use a retinoid, like adapalene, try applying it only every other day and wash it off after 30 to 60 minutes for the first two to four weeks to minimize skin irritation. Combining products: Benzoyl peroxide is a recommended add-on for people who use another antibiotic to treat acne. When taken in combination, benzoyl peroxide helps prevent antibiotic resistance, which can happen when bacteria learn how to outsmart medicines designed to kill them. Be patient and consistent: Acne treatments may take eight weeks or more to work. To find out whether your medicine is effective, take it regularly and allow time for its results to become visible. Remember, everyone's skin responds differently; patience is key. Are OTC Acne Medications Safe for Me? OTC acne medications are safe for most people, but critical considerations to be aware of include the following: Allergies: Read the ingredients label to ensure your product has ingredients to which you're allergic. Precautions: Retinoids can be toxic to fetal development and are not recommended during pregnancy. Ask your healthcare provider for a recommended acne treatment if you're pregnant or breastfeeding. People with eczema should avoid retinoids unless directed to do so by their healthcare provider. People with more melanin in their skin should take caution when using azelaic acid because it can change skin color. Interactions: Using multiple ingredients known to irritate the skin may cause damage and is not recommended. For example, people who use adapalene should be extra cautious with products that contain sulfur or salicylic acid because these can irritate the skin. Apply benzoyl peroxide and the prescription retinoid Retin-A (tretinoin) at different times of the day because they are chemically unstable when combined. As a general rule, do not use abrasive or harsh ingredients unless instructed to by your healthcare provider. When to Contact Your Healthcare Provider OTC medications can be a great starting place for acne treatment. However, sometimes they might not work, have side effects you can't live with, or harm your mental health. Contact your healthcare provider if you experience any of the following: Worsening mental health: Reach out to your healthcare provider promptly if you have concerns while you're dealing with symptoms of acne. Signs that acne is taking a toll on your mental health can include things like avoiding social interactions, worrying excessively, low energy, or the loss of interest in activities you usually enjoy. Don't ignore these symptoms and seek help sooner rather than later. Acne that isn't improving after a few months: If your acne hasn't improved after at least eight weeks of consistently using an OTC product, consider contacting your healthcare provider or a dermatologist. You may need a different product or a stronger prescription medication. Scarring: If you have acne scars, discuss a treatment plan with your healthcare provider rather than self-treating for best results. Taking care of your skin is essential, as is your overall well-being. Seek support if you're facing skin care or acne challenges that impact your mental health. Your healthcare provider can help you explore more effective options tailored to your needs. They may also provide guidance on how your diet and other lifestyle factors may benefit your skin in addition to treatment. Prescription Acne Medication If your OTC acne treatment is not working, you may want to discuss options with your healthcare provider or dermatologist, including prescription medications, such as the following: Topical antibiotics like clindamycin and erythromycin Systemic antibiotics (affecting the entire body) like doxycycline and minocycline Topical retinoids like tretinoin and tazarotene Remember that you can use OTC products together with prescription medicines. For instance, benzoyl peroxide is often added to antibiotic therapy to minimize the risk of antibiotic resistance. Summary Acne is a prevalent skin disorder that can cause physical and mental scarring if not adequately treated. OTC medications are available for treatment. Active ingredients in OTC acne medications include benzoyl peroxide, salicylic acid, adapalene, tea tree oil, and azelaic acid. The best medicine for you may involve trial and error. Some factors to consider include the type of acne you have, your skin type, and the active ingredients of the product. Be consistent in using your acne medication, keeping in mind that it can take months for some products to work. Contact your healthcare provider if your skin worsens or you develop scars. If you notice any changes in your mental health, contact your healthcare provider or call 911 right away.

Dermatologists Say This Acne Wash Stops Underarm Odor—And It's On Sale For Prime Day

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My mom would hate that I'm saying this publicly, but I do not appreciate that I inherited the sweatiest pits ever from her. We both struggle with underarms that sweat profusely, and with sweat comes body odor. Over the years, I've tried dozens of deodorants and antiperspirants, but it was the TikTok-viral PanOxyl Acne Foaming Wash that finally helped me quell my issue. Those struggling with the same thing will be happy to know that it's on sale for 30 percent off during Amazon's Big Deal Prime Days. The shopping event started yesterday, but ends today October 9, so run—don't walk to your cart.

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Acne Foaming Wash 10% Benzoyl Peroxide

amazon.Com

$6.64

When my sister saw that people on TikTok were using the acne wash to kill odor under their arms, she ran to the pharmacy and bought two—one for me and one for my mom. Rather than being offended, I leaned into the curiosity of finding out if it really works. And I can confirm, it does!

Of course, there's science behind its odor-fighting properties. PanOxyl's Acne Foaming Wash contains 10 percent benzoyl peroxide, which is the maximum strength you can get over the counter, and that ingredient helps kill funky smells. "Body odor comes from bacteria, not just sweat," says dermatologist Mona Gohara, MD, associate clinical professor of dermatology at Yale University and a Women's Health advisory board member. "Benzoyl peroxide wash acts an antibiotic to keep the microbes that can cause funk in check." The wash also lifts dirt out of pores, unclogging them to make way for your antiperspirant.

That being said, benzoyl peroxide can be extremely irritating to the skin if you're not used to it. So, if you want to try this body odor hack, less is more. "Just use a bit so you don't get irritated," Gohara says. "It isn't a slather—it's a little bit on the finger tip, let it sit, and then rinse."

I've been using the PanOxyl Acne Foaming Wash as an underarm cleanser for more than two weeks now, and I'm over-the-moon with its results. I find that I don't have to reapply my Secret clinical strength deodorant as much as before. I would literally reapply every hour, but now I stick to two to three times a day. BO sufferers, there is hope, and it's inside this $7 acne wash!

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Your Acne Treatment Could Have Up To 18 Times The Safe Level Of This Cancer-Causing Chemical, CDC Finds

If you've experienced chronic acne, you know there's nothing worse than a flare-up. Whether you're 13 or 30, acne can plummet your self-confidence and lead you to feel like you want to hide away. If acne creams are a mainstay in your grooming routine, listen up. Dozens of acne creams—including popular brands like Proactiv and Clearasil—were recently found to contain high levels of benzene, a cancer-causing chemical. And this isn't the first time.

The US National Toxicology Program (NTP) which includes the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and Food and Drug Administration (FDA) have classified benzene as "known to be a human carcinogen."

Related: Best Acne Treatment for Men of 2024 to Banish Breakouts

The analysis recently published in the Journal of Investigative Dermatology tested more than 100 prescription and over-the-counter benzoyl peroxide acne products that can be found at major retailers nationwide. The acne products ranged from wash-away cleansers and topical creams to gels, lotions, and more. The products were first incubated at body temperature, then elevated similar to how they would be kept during storage and transportation.

Researchers found that nearly one-third of the products were contaminated with high levels of benzene.

Related: How to Get Rid of Acne: The Fastest Effective Treatments

Out of all of the products, Proactiv had some of the highest amounts—around 18 times the amount allowed in U.S. Drugs, to be exact. Similarly, a product owned and crafted by CVS contained 13 times the FDA's recommended safe levels.

"The results presented here suggest that a substantial portion of the BPO [benzoyl peroxide] acne treatment market currently contains unacceptably high levels of benzene in products sitting on the shelf," the study's researchers stated.

This isn't the first time the FDA has been scorned for its lack of attention to cancer-causing chemicals in acne products either. Another report that was published in March of this year also reported high levels of benzene in other acne treatment products containing benzoyl peroxide. The researchers found that some of the products formed more than 800 times the "conditionally restricted" US Food and Drug Administration concentration limit for benzene. With their findings, the lab sent a petition to the FDA urging to recall and suspend the sale of said products.

The FDA responded in a statement saying "The agency acts on information provided from a variety of sources, such as that provided by Valisure, but such data must be verified as accurate and reproducible before it can be utilized to make regulatory decisions such as recommending product sale suspensions and recalls."

Unfortunately, you won't be able to see if a product contains benzene just by looking at its label. If you're concerned about the safety of your products consult lists from independent labs like Valisure or The Environmental Working Group (EWG) to check for products tested for benzene.

Find the list of products studied, here.

Related: Dangerous Carcinogen Found in Common Acne Treatment Products, Lab Says

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