The Best Acne Treatment
How We Found the Best Acne Treatment
30 Hours of Research
43 Treatment Kits Examined
4 Top Picks
The Best Acne Treatment
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 Clear Regular Strength System, is a three-part system designed to unclog pores, heal breakouts, and soothe redness. We liked the dual approach of fighting acne and protecting your skin, making this kit a great starting point for your acne treatments. ($46)
If the ingredients in Paula’s Choice aren’t enough to clear up your acne, consider one of the other treatment kits we liked. The Proactiv+ 3-Step System goes heavier on active ingredients, but will cost you more — even though it’s only $30 for a 30-day supply, you’ll have to use the products two or three times a day to see the best results, which means you’ll run through your supply faster than other treatments.
We also like the Dermalogica Clear Start Kit — in fact, we liked it so much, it almost made our top pick until we realized that the company only sells kits with travel-sized products. At $42, it’s not the cheapest of our recommendations, and if you buy the five products separately (so you have more than a few days’ supply), you’ll be paying closer to $100. But if you’re able to spend more on your skin care, we loved the combination of active and natural ingredients. For a less expensive option, there’s also the Neutrogena Complete Acne Therapy System, which contains a cleanser, control lotion, and sunscreen for just $24.
How We Chose the Best Acne Treatment
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.
Because “acne” encompasses everything from small whiteheads to severe cystic acne, keep in mind that what may work best for one person may not work best for another. If your acne is severe enough that it’s affecting the quality of your daily life, we recommend talking to a doctor or a dermatologist before you begin any treatment. We’ve also included a guide below to help you recognize what type of acne you have, what the common causes are, and how to treat it (or at least not aggravate it).
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. Based 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. Not sure where you fit on that scale? You're not alone! When you're in the middle of a breakout, all acne seems severe, so it can be difficult to self-diagnose your symptoms. We talked to dermatologists and cosmetic chemists to better understand the differences between various types of acne, and have compiled an acne guide below.
One word of caution, though: 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. Our advice: Track your progress while using any over-the-counter treatments, and consider consulting a doctor if your skin continues to worsen or not improve after one month.
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 they're both great at doing entirely different things. Salicylic acid is a beta hydroxy acid that comes from willow bark 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. However, one of its main side effects is dryness: If you’re going to use anything with benzoyl peroxide, make sure to moisturize afterwards. 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.”
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.
We looked for good alcohols that provide moisture, and cut products with simple alcohols that can actually increase the chance of breakouts.
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. But ultimately, we weren’t fans of their inclusion in acne treatment ingredient lists.
There are good alcohols, to.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 is one of the first ingredients listed, meaning it’s a largely alcohol-based formula.
When your acid mantle is damaged, you’re actually more susceptible to breakouts, enlarged pores, and inflammation. 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. If any product included a simple alcohol high up in its ingredients list, we nixed its whole kit.
We eliminated kits with benzoyl peroxide spot treatments to avoid irritation.
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.”
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
If you’re used to seeing advertisements for acne treatments using five or six different products to clear up blemishes, you might be surprised that a simple three-step kit is our top pick. In fact, we favored Paula’s Choice for its simplicity. 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.
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?”
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, which ultimately means spending more money on your treatment. If Proactiv is the only thing that works for you, it may very well be worth that price, but re’d recommending starting with Paula’s choice to see if you can get the same results at a cheaper price.
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 crucial combination of benzoyl peroxide and salicylic acid.
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. We were surprised how much the products appealed to us: We didn’t pay attention to the aesthetics of most acne treatments, but the Clear Start caught our eye in a god way. More importantly, we loved the mix of salicylic acid and benzoyl peroxide, plus all-natural heavy hitters like tea tree oil and witch hazel. And in addition to the wash, toner, moisturizer, and treatments, the kit includes an acne-safe (read: oil-free) sunscreen in its lineup.
Most of our other recommendations will cost you more than the average acne treatment. If you’re looking for something that can treat your breakouts without breaking your budget, try the Neutrogena Complete Acne Therapy System. This three-piece set scores points for including sunscreen, which will help protect your skin while it’s sensitive from treatment.
But know that the cheaper price point isn’t free of drawbacks. The Neutrogena kit 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.
Steps to Success
Know what you're dealing with.
|Severe nodular acne||
|Severe cystic acne||
When trying new acne products, start with small percentages (especially of benzoyl peroxide).
“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. The more comfortable it is to apply, the more likely you are to keep up the regimen.
Get into a routine: 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.
Handle products with care.
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!
Choose your makeup carefully too, especially if used to cover up pimples. 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.
If you’ve found that your skin is too raw and sensitive to handle any treatment at all, don’t despair: there’s still hope. Thi Nguyen, program development specialist in dermatology at pharmaceutical research organization Biorasi, told us: “Patients with sensitive skin are not obligated to use topical products. Modifications like limiting dairy consumption and eating foods that are low on the glycemic index scale can be helpful.” Because skin issues tend to be a combination of genetic, dietary, and external factors, finding a solution to your acne requires more astute sleuthing than brute-force doses of chemicals.
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.”