Why an Over-the-Counter Acne Treatment Is Not Your Best Option

September 19, 2017

When it comes to choosing an over-the-counter acne treatment, there is no shortage of choices. But do these products really work?  If so, are they your best option?

The truth is, acne is more than a simple cosmetic issue; it’s a skin disease that affects some 85% of the population. Acne is different for everyone. It can show up as whiteheads, blackheads or even pus-filled lumps on or under the skin’s surface. Acne can range from mild to severe and can start in your teens and continue well into adulthood.

Whether over-the-counter treatments will improve your acne largely depends on the type of acne you have. Most of the time, acne won’t clear up on its own, and you can’t make it better by simply scrubbing your skin or squeezing your blemishes. In fact, these things can cause the inflammation and acne to worsen.

Though non-prescription treatments can be effective in the mildest cases, most acne requires the attention of a board-certified dermatologist.

Over-the-Counter Active Ingredients

Many over-the-counter acne treatments are designed to “spot treat” mild acne and periodic acne breakouts. These products include different active ingredients that combat acne in different ways. Sometimes, the best treatment plan involves a combination of products and active ingredients.

  • Benzoyl peroxide, the most common over-the-counter acne treatment, is available without a prescription in strengths ranging from 2.5 to 10 percent. It is designed to kill the bacteria that causes acne and help to remove pore-clogging dead skin cells and excess oil from your skin.
  • Over-the-counter alpha hydroxy acids (glycolic acid and lactic acid) help to reduce inflammation, remove dead skin cells and stimulate new skin growth.
  • Non-prescription salicylic acid products, which are available in strengths ranging from 0.5 to 5 percent, work to help prevent pores from becoming clogged.
  • Products containing sulfur — typically combined with other ingredients like salicylic acid or benzoyl peroxide — remove excess oil and dead skin cells that clog pores.

All of these treatments can cause mild side effects including dry skin, stinging and skin irritation. Benzoyl peroxide can also bleach your hair and clothes.

For mild to moderate cases of acne, or periodic breakouts, these products can be effective. But if you have severe or stubborn acne that continues for two to three months after using these over-the-counter acne treatments as part of your daily routine, it’s time to call your dermatologist.

Oral Antibiotics for Cystic Acne

Cystic acne is a serious condition caused by inflammation in pores that have been clogged with dead skin cells, bacteria or oil. When these pores become clogged, the bacteria grow, causing your immune system to react with redness and swelling. The result is a cyst that can rupture and spread the infection to other parts of your skin.

A red, tender, pus-filled bump develops under the skin. It can hurt or itch, and if it bursts, the inflammation can intensify and even lead to permanent scarring.

Over-the-counter treatments won’t work on cystic or recurrent acne. To treat these conditions, your dermatologist may recommend oral antibiotics to lower inflammation and control the bacteria. These antibiotics typically include tetracyclines such as minocycline and doxycycline.

In some cases, acne does not respond to oral antibiotics, or the medication may become less effective after years of use.

Prescription Treatments for Acne

There are a number of prescription-strength creams, gels, and lotions that your dermatologist may recommend. These topical options include benzoyl peroxide and retinoids, which can be used to unclog your pores, kill bacteria, reduce inflammation and help increase the effectiveness of oral antibiotics.

These topical medications are much stronger than the treatment options that are available without a prescription. They can clear your acne and help you avoid further damage to your skin. With many of these drugs, it may take several weeks to see results.

Retinoids like tretinoin (Retin-A, Differin, and Tazorac), adapalene and tazarotene are topical drugs derived from vitamin A. They are designed to prevent hair follicles from becoming plugged. Similarly, topical antibiotics attack excess bacteria on the skin and help reduce overall redness.

Antibiotics are often combined with retinoid treatments or benzoyl peroxide to keep you from becoming resistant to the antibiotics. For example, erythromycin is often combined with benzoyl peroxide to create Benzamycin.

Accutane (isotretinoin) can also be prescribed to treat severe cystic acne that is not responsive to antibiotics. Also, a form of vitamin A, Accutane (and the generic brands Amnesteem, Claravis and Sotret) works by reducing the amount of oil released by the skin’s glands. For most people, a single pill taken once or twice daily for five months clears the skin completely and permanently, but treatment can be repeated if acne recurs.

In some cases, hormones can trigger acne. As a result, oral contraceptives that combine estrogen and progestin can be used to treat acne in some women.

As with any medication, be sure to discuss the risks and side effects with your doctor before starting a new treatment, and let your doctor know if you are pregnant or plan to become pregnant.

Remember: acne therapies take time to work! The goal of most treatment plans is to improve acne by 60 to 70 percent within three to four months, and in many cases, your acne will actually get worse before it gets better.

Those with scarring from severe acne will be happy to know that there are a number of non-surgical treatments that can improve the appearance of your skin. These options include chemical peels, microdermabrasion, soft tissue fillers and laser skin resurfacing.

Looking to Visit a Dermatologist for Acne Treatment?

If you have cystic or recurring acne that has not responded to over-the-counter treatments or scars from past breakouts, contact U.S. Dermatology Partners today. We have multiple locations throughout the country, so fill out our simple online form to get in touch with us. One of our local team members will reach out to you shortly to answer your questions or schedule an appointment for you to visit us soon.

Find a location near me


Find a location