Acne is mysterious—or at least it seems that way. Outside of wondering why it happens in the first place, there's the trial, error, and subsequent frustration that comes along with treating it. One person swears their acne was cleared by using only oil-free skincare products. Another person claims anti-inflammatory facial oil is what did the trick for them. While there's nothing wrong with taking advice from other people, it's disorientating and contradictory when it's coming at you from all angles.
Meet the Expert
Dr. David Lortscher says, "It's important to note that acne is very much multifactorial, with hormones, genetics, lifestyle, diet, fabric choices, exercise/sweating, choice of skincare products, and more all possibly influencing the different stages of acne development. Thus, the ease of acne treatment is very specific to the individual, and sometimes expert care from a dermatologist is needed." With that being said, there are a few tried-and-true practices, products, and ingredients you can turn to in order to prevent breakouts and the redness, inflammation, soreness, and scars that can result from them.
The Best Anti-Acne Skincare Ingredients
There are some acne ingredients that seem ubiquitous. They're classics because they work. We're talking about ingredients like benzoyl peroxide, sulfur, BHA (salicylic acid), and AHA (glycolic acid or lactic acid). You'll find these ingredients in all kinds of acne treatments, including those at the drugstore. They're the first ingredients to turn to when it comes to mild breakouts. "I advise starting with one ingredient before adding another to evaluate how your skin tolerates the first ingredient without dryness or irritation," Lortscher says.
If your acne is stubborn and it requires something more, that's when you can turn to other over-the-counter treatments like adapalene, which most people are most familiar with when referred to by the brand name: Differin. It's widely available at drugstores, no prescription needed. Take it from this writer—it works. I apply a bit of the milky gel on clean skin and go to bed. In the morning, any blemishes are visibly smaller and much, much easier to disguise with a dab of concealer.
Another ingredient that's derived from vitamin A, like adapalene, is called tretinoin. This one is only available via prescription. "At Curology, we use tretinoin in some of our prescription acne and anti-aging medications, as decades of research confirm tretinoin as the 'gold standard' in topical treatment for fighting acne and clogged pores, as well as reducing fine lines, unwanted pigmentation, and improving skin texture," Lortscher says.
Niacinamide and Zinc Pyrithione
Other effective acne-fighting ingredients include niacinamide, which "is an antioxidant derived from vitamin B3 that fights acne while keeping inflammation and dark spots at bay." There's also zinc pyrithione, which is "an antimicrobial that inhibits bacteria and fungi from multiplying, helping to treat acne and blocked pores." You can find it in Vanicream's 2% Medicated Z Bar ($10), which Lortscher recommends as an anti-acne face wash.
Clindamycin and Azelaic Acid
Lastly, there's clindamycin and azelaic acid. The former, "is another anti-inflammatory ingredient that can help with redness," Lortscher says. "Clindamycin is popular because it helps prevent acne bacterium from triggering your pores to make excess sebum (oil)." Azelaic acid, on the other hand, unclogs pores, fights dark spots, and reduces redness, as well as acne-causing bacteria and inflammation.
Be Patient When Trying New Treatments
No matter which over-the-counter treatments you choose, Lortscher says patience is key. We know that's easier said than done for acne-sufferers, but there's no way around it. "It's important for people to keep in mind that there's really no such thing as a one-size-fits-all cure for acne. I recommend a range of OTC products containing zinc pyrithione, salicylic acid, benzoyl peroxide, or sulfur. Each person's skin is unique, so it's best to test these different ingredients to see which one best suits your skin."
And whatever you do, don't give up on an acne treatment too quickly. "I often see patients who give up on their acne treatment too soon when it's too early to tell how their skin is responding. Typically, we can't judge how a patient is responding to acne treatment until at least six to eight weeks have passed, although most patients will see improvements in three to four weeks."
As for ingredients to avoid, Lortscher recommends straying far from coconut oil and shea butter, which can both clog pores and bring about more acne for people predisposed toward it. He cautions to check labels and ingredient lists. "I suggest that you read labels for the base (inactive) ingredients as well just to be safe, and avoid isopropyl myristate, laureth-4, or sodium lauryl sulfate, which can worsen acne breakouts in some people."
The Best Anti-Acne Skincare Routine
As far as the recommended acne routine goes, it's all about simplicity. It's easy to go overboard with treating acne (believe us, we know) by applying myriad different spot treatments and masks, but too much too soon can just irritate the skin further. Lortscher recommends a simple a.m. and p.m. care routine.
Step One: Cleanse
In the morning, wash your face with something gentle. Lortscher likes Humane's Benzoyl Peroxide Acne Wash ($21), which has 10% benzoyl peroxide and can be used on both the face and the body.
Step Two: Tone
There are substitutions and additions you can make based on your specific skin needs. For example, Lortscher says while you don't need a toner, you can use one if you prefer. Just make sure to choose one that's alcohol-free. People with acneic skin often find toners helpful.
Step Three: Moisturize
Seriously—that's it. Use a moisturizer. It's deceptively simple.
Step Four: SPF
Lortscher says to keep sun protection in mind, especially during times of year where sun exposure is high. "As we head into summer, those with fair or sensitive skin (like I have) may want to reduce or stop usage of products that have the potential to make the skin more sensitive to the sun, such as AHA (alpha hydroxy acids), retinol, and prescription retinoids." He also says to lighten up product usage as the days get warmer and longer. In other words, don't use a heavy winter moisturizer in July. Try to keep your skin happy and hydrated with simple, lightweight formulas.
Add a Vitamin C Product to the Mix
The only thing he would add to that routine, optionally, is a vitamin C product. "I add an antioxidant on a daily basis to fortify my skin against ultraviolet damage. Vitamin C has the most research behind it and has been shown to stimulate collagen production to repair fine lines and wrinkles and inhibit melanin formation. A vitamin C serum, such as Paula's Choice Resist C15 Super Booster ($49), can be a great addition to your regimen either in the morning before sunscreen or at night."
At night, wash your face again and add moisturizer.
Aside from small tweaks, this is a good anti-acne baseline to follow. Although it's simple, it's effective. Most importantly, it's dermatologist-recommended. If breakouts are troubling you, start with a good-for-skin routine and ingredients like these, and then work with a dermatologist to tailor it to your needs.
Tan AU, Schlosser BJ, Paller AS. A review of diagnosis and treatment of acne in adult female patients. Int J Womens Dermatol. 2017;4(2):56-71. doi:10.1016/j.ijwd.2017.10.006