The range of acne spot treatments is huge, encompassing many prescription and over-the-counter options. The right choice depends on the type, severity, and cause of a person’s acne.

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In this article, we describe six of the best acne spot treatments, looking at the most effective ingredients and how they work.

Please note, however, that the statements below are based only on research. No one at Medical News Today, including the writer, has tried these products.

Around 85% of all teenagers and 12% of adult females have acne. The condition affects approximately 50 million people in the United States and can have a significant impact on mental health.

People with acne may experience anxiety, depression, and negative self-image. They may also develop scarring as the acne heals. Overall, effective acne treatments can make a big difference to a person’s quality of life and their self-esteem.

However, finding a treatment that works can be difficult, because a number of factors can contribute to the development of acne, including:

  • the presence of acne-causing bacteria on the skin
  • how much oil, or sebum, the skin produces
  • hormone imbalances
  • disorders such as polycystic ovary syndrome
  • inflammation
  • genetic factors
  • the person’s diet

Because of the variable causes, what works for one person may not work for another. Often, people need to try a combination of approaches to see lasting improvement.

The following sections look at some of the best acne treatments and how they work. Some are available without a prescription, while others require a professional diagnosis.

It is important to note that several acne treatments increase sensitivity to sunlight. A person should wear a non-irritating sunscreen while using acne treatment.

Benzoyl peroxide

This helps kill Propionibacterium acnes, a species of bacteria associated with acne. It is available in over-the-counter creams and other products, but a doctor may prescribe a stronger version.

A product may contain 2.5–10% benzoyl peroxide. People with sensitive skin should start with a lower concentration or use wash-off products to avoid irritation and dryness.

People with mild, moderate, or severe acne who use benzoyl peroxide continuously may notice an improvement after just 5 days.

A doctor may recommend using it in combination with other topical acne treatments, such as retinoids, to increase its impact.

Benzoyl peroxide acne treatments are available for purchase online.

Salicylic acid

This exfoliates, removing dead cells and smoothing the surface of the skin. It may also help treat mild-to-moderate outbreaks.

In a 2018 study, researchers found that a 2% salicylic acid product was just as effective at reducing acne as a more traditional benzoyl peroxide and adapalene treatment over 28 days. However, as this was a pilot study, researchers need to carry out larger trials to verify the results.

A key advantage of salicylic acid is that people usually tolerate it well, even if they have sensitive skin.

Salicylic acid products for acne typically have a concentration of 0.5–2.0%, with many strengths and formulations available over the counter.

Acne treatments containing salicylic acid are available for purchase online.

Retinoids

Retinoids are a group of substances derived from vitamin A. For acne, they work by reducing inflammation and preventing the formation of pimples.

Topical retinoids include ingredients such as retinol, tretinoin, adapalene, and tazarotene.

While a number of high-quality studies have found that retinoids are effective against all types of acne, they can cause side effects, such as dryness, peeling, and irritation. In this case, reducing the strength and frequency of application can help.

It is crucial to note that retinoids and other forms of vitamin A can cause birth abnormalities — anyone who is pregnant or trying for a baby should speak with a doctor before using reintoid products.

Topical retinoids are available for purchase online.

Azelaic acid

Azelaic acid is mildly antibacterial and anti-inflammatory, and it may help treat acne. However, doctors are not quite sure how it has this effect. As a result, they may only recommend it as an add-on or extra treatment.

This acid is available in concentrations of up to 20%. It may also lighten darker marks left by acne as it heals.

Topical antibiotics

Doctors prescribe these for mild, moderate, or severe acne, and they work by killing bacteria and reducing inflammation.

Usually, doctors prescribe topical antibiotics in combination with other treatments, reducing the chances of the bacteria becoming resistant to the medication.

A doctor may recommend clindamycin or erythromycin, both of which are effective against P. acnes and Staphylococci bacteria. However, compared with erythromycin, clindamycin is more effective.

Comedo removal

Comedo removal, or extraction, involves a dermatologist removing blackheads or whiteheads.

There is limited evidence of its effectiveness, but some researchers believe that it can help manage acne that does not respond to other treatments.

Do not attempt to remove comedones at home, as this can cause scarring and infection.

Some companies sell herbal remedies for acne. However, for the most part, there is not strong evidence that these ingredients work, according to a 2016 review.

For example, scientists have assessed the potential of the following to treat acne:

  • essential oils, such as basil, tea tree, or rose (Rosa damascena)
  • clays and muds, such as Dead Sea mud
  • seaweed
  • green tea

Some of these ingredients are antibacterial, while others reduce general skin inflammation. However, researchers need to carry out more studies to better understand how they work and how effective they are.

Speak to a doctor before using natural acne treatments. This is especially important for people who have preexisting conditions or are pregnant.

Also, always dilute essential oils in a carrier oil, such as jojoba, at a concentration of 1.5% or less before applying it to the face.

If a person experiences any adverse reactions to a natural acne treatment, they should stop using the product and speak to a doctor.

Although research suggests that essential oils may have some health benefits, it is important to remember that the Food and Drug Administration (FDA) do not monitor or regulate the purity or quality of these. A person should talk with their healthcare provider before using essential oils, and they should be sure to research the quality of a brand’s products. A person should always do a patch test before trying a new essential oil.

A range of ingredients can treat acne, including benzoyl peroxide, salicylic acid, and retinoids. Many products containing these are available without a prescription.

However, acne treatments — even herbal ones — can cause side effects or adverse reactions, so it is a good idea to discuss any treatment with a doctor first.