The Best Acne Treatment
Hit your zits with a one-two punch
Treating acne can be a months-long exercise in patience finding the right set of products for your skin. We read the double-blind studies, then talked to dermatologists and aestheticians to see which kits have the right combination of salicylic acid and benzoyl peroxide to really work — and not make your acne worse.
This twice-daily three-step kit includes a cleanser, an anti-redness exfoliant, and a leave-on treatment. It is lightweight, fragrance-free, and treats your breakouts with TLC.
In September 2016, the FDA released a study stating that triclosan, an antibacterial agent, is no longer recognized as safe or effective. Triclosan shows up in the cleanser of our top pick, Paula’s Choice Clear Regular Strength System. We’ve reached out to inquire if Paula’s Choice will be updating its cleanser formula. In the mean time, if you’re worried, go for our runner-up, Proactiv+ 3-Step System.
Nobody thinks popping pimples is a good idea. But it’s just so satisfying — mostly because you can actually see something happening. Contrary to the marketing promises of “blemish banishers” and “zit zappers,” immediate results are not the trademark of acne treatments, a frustrating truth to anyone suffering through a breakout. And while pimples are personal (your stress-induced spots will look and act differently than your best friend’s breakout), the best acne treatments will include a regimen of products to hit all of acne’s root causes. Our top pick, Paula’s Choice Regular Strength Clear Acne Kit, is a three-part system designed to unclog pores, heal breakouts, and soothe redness.
Acne vulgaris is the catch-all term for everything from angry red lesions to tiny white bumps, which are the results of hair follicles and their sebaceous glands becoming blocked and inflamed — how vulgar indeed. Genetics plays 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 Propionibecterium 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.
How We Found the Best Acne Treatment
Our first plan was to look at it all — spot treatments, washes, scrubs, and creams — until we learned that when it comes to over-the-counter treatments, there is no one single cure. A 2013 study on acne vulgaris in The Nurse Practitioner concurred that, in most cases, a multidimensional approach to acne is necessary because most people have a combination of symptoms. On the advice of dermatologists and aestheticians, we turned our focus to regimen sets, analyzing the ingredients of more than 40 kits before finding our top picks.
I recommend acne kits because sticking to one product line, with products designed to work well with one another, will have the most effective results.
Keep in mind that even if some products market themselves toward severe acne breakouts, all the kits we looked at are definitely designed for mild to moderate acne. Dr. Lawrence Green, board-certified dermatologist and assistant clinical professor of dermatology at George Washington University, warns that even moderate acne can be beyond what an over-the-counter treatment can handle, and recommends seeing a specialist. Granted, if you’re in the middle of a breakout, every pimple seems pretty severe (and if your acne feels out of control, you might be desperate to try anything). Good thing the Journal of Clinical and Aesthetic Dermatology published a study to determine if people could self-diagnose their level of acne. The researchers found that, with this handy chart, you can!
Severe nodular acne
Severe cystic acne
We looked for kits with at least two active ingredients proven to fight acne.
There are two big guns used to take down acne (and a few little Berettas), and they are both great at doing entirely different things. Salicylic acid is a beta hydroxy acid that comes from willow bark, which is just to say that it’s naturally occurring and works primarily as an exfoliator, breaking down fatty acids like sebum so your pores don’t clog. (Glycolic acid works similarly, but is less effective.) These acids do their thing on comedones — whiteheads, blackheads, and other non-red bumps.
Benzoyl peroxide attacks the P. acnes bacteria. Once it’s on your face, benzoyl peroxide breaks into oxygen and benzoic acid, which rip through the bacteria’s membranes. Sulfur and azelaic acid are less common and less severe alternatives to benzoyl peroxide, which can sometimes leave skin dry and irritated. “I use sulfur-based treatments a lot in adults,” says Dr. Peter Lio, assistant professor of clinical dermatology at Northwestern University. “It’s a good fit for patients who can’t tolerate the side effects of benzoyl peroxide.” All three of these ingredients go after those big red pimples.
The Journal of Clinical and Aesthetic Dermatology states that salicylic acid and benzoyl peroxide are by far the most common acne ingredients and they’re effective in double-blind studies of patients with mild-to-moderately severe acne. We looked for kits that included at least one ingredient targeting each camp: the comedones and the pimples.
AcneFree 24 Hour Acne Clearing System, AcneFree Severe Acne 24 Hour Clearing System, Andalou Naturals Get Started Clarifying Kit, Arcona Problem Skin Starter Kit, Benzac Complete Acne Solution Regimen, Burt’s Bees Natural Acne Solutions Regimen Kit, Clinique Acne Solutions Clinical Clearing Kit, Dermalogica Medibac Kit, Evologie Evolgoie Trio, Juice Beauty Blemish Clearing Solutions Kit, Kate Somerville 24 Hour Pimple Punisher, Kate Somerville Now You See It, Now You Don’t! Kit, Mario Badescu Acne Repair Kit, Mario Badescu Acne Starter Kit, Murad Anti-Aging Acne Starter Kit, Murad Acne Mini Cleanser Set, Nature’s Cure Two-Part Body Acne Treatment, Olay Fresh Effects Clear Skin Acne Solution System, Philosophy Clear Days Ahead 30 Day Acne Trial Kit, Proactiv Deluxe Kit, Proactiv Solution 3-Step System, Skin Authority Fit & Clear Kit, Yes to Tomatoes 3-Step Acne Fighting and Clear Regimen Kit
Simple alcohols were an automatic cut.
Isopropyl alcohol, SD alcohol, and denatured alcohol are everywhere in acne treatment because they trick you into thinking they’re working: Splash some on and any oil on your face instantly vaporizes. (Granted, there are other less nefarious reasons for alcohol too, such as helping vitamin C penetrate the skin.)
There are good alcohols too. Fatty alcohols — anything prefaced by cetyl, cetearyl, or behenyl — come from oils and actually provide moisture.
Simple alcohols destroy the skin’s barrier, called the acid mantle, which is what keeps your skin’s pH in its happy place (and your skin blemish-free). “A lot of products that are marketed to treat acne do not maintain — or even consider the importance of — the skin’s acid mantle,” explains Natarsha Bimson, a Los Angeles-based aesthetician. “It’s a huge issue.” In one study, even a small, 3 percent alcohol solution applied to skin cells over the course of two days increased cell death by 26 percent — in some acne treatments, like Kate Somerville’s EradiKate, alcohol makes up the majority of the treatment!
When your acid mantle is damaged, you’re actually more susceptible to breakouts, enlarged pores, and inflammation (aka acne). To make matters worse, evaporating all the oil on your face can actually set your sebaceous glands into overdrive, leaving your skin oilier than ever. Talk about counterproductive. If any product included a simple alcohol high up in its ingredients list, we nixed its whole kit.
Bliss No ‘Zit’ Sherlock Complete Acne System, Clean & Clear Advantage Acne Control Kit, Clearogen Three Step Acne Treatment Set, Clinique Acne Solutions Clear Skin System Starter Kit, Clinique Clean Skin, Clear Skin Acne Solutions Sonic Cleansing Brush Set, Dr Dennis Gross Skincare Clear Skin Solutions Acne Kit, Kate Somerville Blemish Banisher Kit, La Roche-Posay Effaclar System, Obagi CLENZIderm MD Acne System, Proactiv+ Complete Kit
We eliminated kits with benzoyl peroxide spot treatments.
Spot treatments are designed to give problem pimples a mega-dose of concentrated benzoyl peroxide — in a couple of regimens, like the Proactiv Teen Kit, the spot treatment had nearly three times the benzoyl peroxide as its all-over treatment. It makes sense: If benzoyl peroxide can be irritating to the skin in high concentrations, limiting its intensity to just the pimple itself could save the rest of your healthy skin.
But the side effects of targeted spot treatments aren’t always worth it. “So many products instruct consumers to use benzoyl peroxide to spot treat red bumps and pustules. I don’t recommend it,” says Dr. Green. “Benzoyl peroxide, when placed on red spots, can actually cause more irritation and inflammation to the area. It’s best used to prevent red bumps and pustules, and applied all over the area you want to treat.” Robin Townsend, a medical aesthetician based in Cincinnati, was also quick to naysay a spot-treat-only approach: “Acne affects all of the pores. If someone is going to spot treat against my advice, I still suggest they spot treat one day and treat the whole face the next.”
AcneFree Sensitive Skin 24 Hour Clearing System, Murad Complete Acne Control Kit, Proactiv Teen Kit, Proactiv+ Teen Kit
With six acne treatments left in the running, we dug deeper into their ingredients and went through their regimens to find which ones worked hard on acne, yet felt great on the skin.
Our Picks for the Best Acne Treatment
This system might not have the most products. And its percentage of active ingredients may not be the highest. But this twice-daily three-step kit — which includes a cleanser, an anti-redness exfoliant, and a leave-on treatment — is concise without cutting corners.
Don’t let the lack of any active ingredients in the Pore Normalizing Cleanser throw you off. This gentle gel is designed just to cleanse, not treat, which is a good thing: The Nurse Practitioner study emphasizes the importance of washing with mild cleansers in conjunction with topical acne medications to combat or avoid excessive skin irritation. This one is water-based and fragrance-free, and uses sodium laureth sulfate (as opposed to its harsh cousin sodium lauryl sulfate) to eliminate any chance for irritation.
This three-piece set may not be the most comprehensive acne solution available, but we liked the balanced approach to fighting acne while also protecting skin.
The Anti-Redness Exfoliating Solution is mostly water, but its 2 percent salicylic acid is enough to eat through oil and slough off the dead skin cells clogging your pores — and it boasts a higher concentration than nearly every other kit we looked at. It sloshes out quickly (so have your cotton balls at the ready), but stroking it over your face and neck per the instructions is pure heaven. It’s cooling on the skin and leaves a lingering tingle that never turns into a burn. Sodium hyaluronate, the super-moisturizing humectant we fell in love with in our review on the best face moisturizer, also caught our eye sitting smack dab in the middle of the ingredients list.
Rounding out the Clear Acne kit is the Daily Skin Clearing Treatment, an all-over 2.5 percent benzoyl peroxide cream that also touts calming bisabolol and allantoin to alleviate the dryness and irritation that can crop up mid-treatment. Anyone frustrated with oil-slick skin will also love this part of the regimen — it creates a satin mattifying effect, instantly transforming shininess into a glow.
The three-piece set doesn’t come with an SPF, but Paula’s Choice has one in the line, the Clear Ultra-Light Daily Fluid SPF 30+. “Sun protection is really important, especially with acneic skin,” says Townsend. “In many cases, stronger acne products can make the skin photosensitive to the sun.” This isn’t your normal gloppy white sunscreen. Its fluid formula slips over tender skin, doesn’t need a ton of rubbing in, and also leaves a mattifying finish.
If you give the Regular Strength kit a try and don’t see the results you want, Paula’s Choice also has an Extra Strength Clear Acne Kit that boosts the Daily Skin Clearing Treatment up to 5 percent benzoyl peroxide (and replaces the sodium hyaluronate in the exfoliant with green tea extract) to give your acne a real kick. But we recommend starting with the regular strength version. “When it comes to strong products, less is more,” Townsend says.
All of Proactiv’s regimens are heavy on the benzoyl peroxide, and the Proactiv+ three-step kit is no different: a 2.5 percent benzoyl peroxide wash, a 2.5 percent benzoyl peroxide gel, and a 0.5 percent salicylic acid moisturizer.
The Pore Targeting Treatment gel and Complexion Perfecting Hydrator moisturizer slip on nicely, with the former powered by skin-loving glycerin and the latter by a whole slew of delicious ingredients, including licorice root extract, sodium hyaluronate, bisabolol, and allantoin. We are iffy on the Skin Smoothing Exfoliator face wash, though, and not only because the microbead granules can be harsh on active breakouts. “Acne products that are washes will tend not to work as well as leave-on or rub-in products,” explains Dr. Green. “Think about it. How well can a product work when rinsed off a few seconds after you put it on?”
Proactiv offers a number of acne kits, but Proactiv+ is the one to get thanks to better ingredients and a lack of unnecessary steps.
The other downside to Proactiv+ is that the bottles are small. Like, half the size of Paula’s Choice small. Combine that with its recommended two- or three-times daily application and you’re going to be going through a lot of kits.
If you do pick Proactiv, this is the kit to get — both teen kits have unnecessary spot treatments and classic Proactiv (without the plus) doesn’t have the one-two punch of benzoyl peroxide and salicylic acid.
Other Acne Treatments to Consider
Dermalogica sells its full-size Clear Start products a la carte (all at around $20 — this line is definitely not made for the thrifty) and there are even more options than the five in the travel kit. The products themselves are gorgeous, with a mix of salicylic acid and benzoyl peroxide, plus all-natural heavy hitters like tea tree oil and witch hazel. Even better: In addition to the wash, toner, moisturizer, and treatments, the kit includes an acne-safe (read: oil-free) sunscreen in its lineup.
Dermalogica’s five-piece set definitely impresses, but the only kit option available features tiny travel-size products.
This three-piece set scores points for including sunscreen, but misses the mark with its Skin Polishing Acne Cleanser. It’s the only product in the kit with salicylic acid, and you end up washing it all off anyway. A recent “formula improvement” in the acne control lotion has left customers leaving less-than-pleased comments on the Neutrogena website too.
While the inclusion of sunscreen is appreciated, Neutrogena’s three-piece set didn’t quite stack up to our top picks.
Did You Know?
The intensity of the active ingredients matters, but you can’t compare acne treatments on that alone.
“You unfortunately cannot determine the strength of a product strictly by the percentage of its active ingredients because how well a product works depends on how well its inactive ingredients help it penetrate the skin,” explains Dr. Green. “In other words, a 2 percent benzoyl peroxide may be more effective than another brand’s 5 percent benzoyl peroxide because there are other ingredients helping out.”
When we asked what those types of other ingredients are, Dr. Green said there were no clear answers there either — skin is too subjective. “I think the best answer is to use one that feels good and rubs into your skin well without over-drying it,” he says. When trying new acne products, start with small percentages (especially of benzoyl peroxide), and pay close attention to the whole experience. The more comfortable it is to apply, the more likely you are to keep up the regimen.
Because getting into a routine is key: You’re in this for the long haul.
Every expert we spoke with said the most critical part of combatting acne is combatting it every day. “The only way to make any medication work is to use it on a daily basis,” says Dr. Green. Jessica Fitz Patrick emphasizes that it really comes down to what you can maintain for the long term: “Kits are great because they take out all the guess work — you just follow the instructions. But if four steps is going to be too many for you to keep up week after week, you’ll be better off finding one that has fewer treatments.”
That’s right. Any acne treatment is a weeks-long experiment that you’re conducting with your skin. Acne is slow to heal, and in some cases, it can get worse before it gets better (nearly every benzoyl peroxide product we looked at emphasized the likeliness of irritating acne further, and starting off with a lighter application). April W. Armstrong, a doctor at the University of California Davis Health System, recommends waiting at least one month before you deem a product ineffective, and Townsend agrees.
In most cases, acne products need to be used for at least 30 days before you can begin to ascertain its efficacy. Some skin and acne types may see noticeable results in a few days and end up totally clear in just a few weeks. Others may take several weeks to see the slightest change, or need to have their regimen adjusted as their skin adapts. Treating acne can often be a months-long process.
More isn’t better.
Impatience for acne to be better right now usually results in less-than-healthy habits. Your pimples need TLC too. That 2013 study on acne vulgaris found that, in an attempt to dry out acne lesions, patients often use too many products or apply excessive amounts to problem areas, resulting in further irritation and overdrying the skin. Vigorous scrubbing and using harsh exfoliants (remember that St. Ives Apricot Scrub we were all crazy about in the early 2000s?) can make acne worse by rupturing whiteheads and blackheads, and turning them into painful red ones. And remember: No matter how satisfying it is, picking and popping your zits will also increase their inflammation and opportunity for infection. Resist!
The Bottom Line
We love Paula’s Choice Regular Strength Clear Acne Kit for its balance of active and inactive ingredients — plus the option to upgrade to an Extra Strength version — but you may have to experiment to find out what works best for your breakouts. We recommend trying something new if you don’t see improvement after six weeks.
Take stock of your spots. Are your blemishes a majority of red pimples or white bumps? For the former, tailor your regimen to a benzoyl peroxide-heavy ingredients list, like Proactiv+ 3-Step System. For the latter, Paula’s Choice will be a better place to start.
Check the labels on your makeup. Acne treatments can be made moot if you pile on pore-clogging cosmetics. Look for labels that state non-comedogenic — or get started with our review on the best foundation.
Talk to a skincare pro. If your acne is severe, painful, or refusing to get lost, you may just be beyond what an over-the-counter treatment can do. Not only can a professional set you up with the really powerful stuff, but also Fitz Patrick explains that “working closely with an aesthetician or dermatologist means you can keep tweaking a routine to make it work best for you.”