Acne (Acne Vulgaris)

Overview

Acne is the most common skin condition in the world. Around 85% of teenagers get it, and plenty of adults deal with it too. It starts when pores get clogged with dead skin and oil, a normal skin microbe called C. acnes multiplies, and the area becomes inflamed. That mix shows up as blackheads, whiteheads, red swollen pimples, and sometimes deeper cysts. Left untreated, acne can leave behind dark marks, lingering redness, and scars, so it's worth treating early instead of waiting it out.

Evidence anchors

• guideline

  Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-973.e33.

  PMID:26897386View source ↗
• guideline

  Nast A, Dréno B, Bettoli V, et al. European evidence-based (S3) guideline for the treatment of acne — update 2016. J Eur Acad Dermatol Venereol. 2016;30(Suppl 3):1-185.

  PMID:27514932View source ↗
• systematic review

  Yoham AL, Casadesus D. Tretinoin. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024. (Pivotal systematic review of retinoid evidence for acne.)

  PMID:32491329View source ↗
• systematic review

  Fabbrocini G, Annunziata MC, D'Arco V, et al. Acne scars: pathogenesis, classification and treatment. Dermatol Res Pract. 2010;2010:893080.

  PMID:20981308View source ↗
• review

  Kraft J, Freiman A. Management of acne. CMAJ. 2011;183(7):E430-5.

  PMID:21398228View source ↗
• review

  Tan JKL, Bhate K. A global perspective on the epidemiology of acne. Br J Dermatol. 2015;172(Suppl 1):3-12.

  PMID:25597339View source ↗

Ingredients that help

• Benzoyl Peroxidestrong

  Kills the acne bacteria (C. acnes) on contact inside the pore. The bacteria cannot become resistant to it, so it is the key partner that keeps topical antibiotics working. It also helps clear clogged pores a little. The AAD 2016 guidelines give it their top (Grade A) recommendation for both pimples and blackheads/whiteheads at 2.5-10%. The lower strength (2.5%) works just as well with less dryness and less bleaching of fabric.

  PMID:26897386
• Salicylic Acidstrong

  Unclogs pores by clearing out the dead skin and oil that block them. It is a BHA (beta-hydroxy acid), and because it dissolves in oil it can get down into oily, blocked pores in a way that AHAs cannot. At 0.5-2% it breaks up the plug, stops new clogs from forming, and calms a little inflammation. That oil-loving quality makes it the go-to exfoliant for acne-prone skin. AAD and European guidelines recommend it as a first-choice over-the-counter treatment, used on its own, for blackheads, whiteheads, and mild pimples.

  PMID:26897386
• Tretinoinstrong

  Keeps pores from clogging in the first place, and speeds up how fast your skin sheds the plugs it already has. It is the best-proven prescription retinoid (a vitamin A treatment) for acne. It also helps other treatments like antibiotics and benzoyl peroxide work better when used alongside it. Strong trials show 0.025-0.1% strengths beat a plain base cream for both clogged pores and pimples. It has the AAD's top (Grade A) recommendation. It is a first choice for blackheads and whiteheads, and a preferred part of combination routines for moderate to severe acne.

  PMID:26897386
• Niacinamidemoderate

  Calms redness and inflammation, cuts down oil, and fades the dark marks acne leaves behind. It is vitamin B3. In a 1995 trial (Shalita et al., PMID:7771923), 4% niacinamide gel worked as well as 1% clindamycin (a prescription antibiotic) for inflamed acne after 8 weeks. It is safe to use during pregnancy and gets along with every other active in your routine, so it is an easy one to keep using long term.

  PMID:7771923
• Azelaic Acidmoderate

  Unclogs pores, kills acne bacteria, and calms inflammation, all at once. At 15-20%, trials show it works as well as 5% benzoyl peroxide and as well as the oral antibiotic tetracycline for mild to moderate inflamed acne. It also fades the dark marks acne leaves behind by targeting only the over-active pigment cells, so it does not lighten the rest of your skin or make you sun-sensitive. It is considered safe in pregnancy (category B). AAD and European guidelines list it as a good alternative when benzoyl peroxide or retinoids are too harsh for you.

  PMID:26897386
• Retinolmoderate

  Helps keep pores clear so fewer clogs and breakouts form. It is an over-the-counter retinoid (a vitamin A treatment). Your skin converts it into the same active form as tretinoin, just in two steps, so it works the same way but more gently. The proof behind it is not as strong as tretinoin's, but it is a solid choice when you cannot get a prescription. Start at 0.025-0.05% and build up slowly.

  PMID:26897386
• Glycolic Acidmoderate

  Exfoliates the surface and loosens the dead skin that blocks pore openings. It is an AHA (alpha-hydroxy acid) and the smallest one, so it sinks in easily. Trials of 10-15% peels show real improvement in clogged pores and mild pimples over a 12-week course, and at-home strengths (5-10%) keep up the progress. It is especially handy for blackheads, whiteheads, and the dark marks left behind. Do not use it the same night as a retinoid (together they can over-irritate).

  PMID:21398228
• Tea Tree Oilemerging

  Helps fight acne bacteria and calm inflammation. It is a plant essential oil (its main active is terpinen-4-ol). In one small trial (Bassett 1990, PMID:2145499), a 5% tea tree oil gel matched 5% benzoyl peroxide for total breakout count at 3 months, with fewer side effects. The proof is limited to small studies. Use it only at a standard 5% strength. Undiluted tea tree oil can trigger strong allergic reactions on skin.

  PMID:2145499
• Centella Asiaticaemerging

  Calms redness and helps skin heal after a breakout. This plant extract eases inflammation, speeds wound repair, and supports collagen, which helps with the lingering pink marks and early scars acne can leave. There are no studies counting how many pimples it clears, but the way it works is well understood and it is widely used in Korean routines to settle post-breakout redness and help skin recover after a retinoid or benzoyl peroxide.

• Zinc Oxideemerging

  Protects skin from the sun without clogging pores, and calms inflammation a little. It is a mineral. People with acne are more likely to be low in zinc, and zinc taken by mouth has trial support for mild acne. As a sunscreen filter, zinc oxide matters because sun exposure darkens post-acne marks, and many acne treatments (retinoids, BHA, benzoyl peroxide) make your skin more sun-sensitive. It is the preferred sunscreen filter for acne-prone skin.

• Hyaluronic Acidemerging

  Adds light hydration without clogging pores. That matters because drying acne treatments (benzoyl peroxide, salicylic acid, retinoids) can strip your skin. When skin gets stripped, it can react by making more oil, which makes acne worse for some people. Hyaluronic acid is a helper that keeps your skin comfortable while you use those treatments, not an acne treatment on its own.

• Panthenolemerging

  Soothes irritation and helps your skin barrier recover. It is pro-vitamin B5. It speeds up healing and calms redness a little. In an acne routine it is handy for settling the dryness and stinging that benzoyl peroxide and retinoids can cause. Taking pantothenic acid by mouth may cut down oil, but there is not much proof that putting B5 on your skin clears pimples directly.

• Ceramidesemerging

  Rebuilds your skin barrier without clogging pores. Acne-prone skin tends to be low in ceramides (the fats that hold the barrier together), and harsh cleansing or strong treatments can damage it further. A ceramide moisturizer repairs that, so your skin is less likely to overreact and pump out more oil after being stripped. AAD guidelines suggest using a moisturizer like this during acne treatment so the dryness from retinoids and benzoyl peroxide does not make you quit.

Ingredients that aggravate

• Snail Mucin

  Snail mucin is a thick, hydrating mix of proteins and repair factors. Most people tolerate it well and it helps the skin barrier. The catch is the thick, sealing texture, which can trap things in your pores if you have severe deep or cystic acne. It is fine for mild to moderate acne and for recovering after a breakout. Be careful with badly inflamed cysts, where anything sealing can make the congestion worse.

Suggested routine

Watch out for these on labels

Specific irritants from our watchlist that the research pack identifies as aggravating for acne (acne vulgaris).

Products from our catalog

• COSRX · Low pH Good Morning Gel CleanserCleanser

  A low-pH cleanser with salicylic acid at a rinse-off strength, so it gently clears pores every day without drying you out. It is a great morning cleanser for oily, acne-prone skin. Its low pH lets the salicylic acid work and keeps your skin slightly acidic. Many regular cleansers leave skin too alkaline, which can make acne worse.

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• CeraVe · Foaming Facial CleanserCleanser

  Ceramides and niacinamide in a foaming cleanser that lifts off extra oil without stripping your skin. It is the kind of cleanser AAD recommends for mild acne: it does not clog pores and has no fragrance. Best for combination to oily skin that does well with a light foam.

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• Paula's Choice · Skin Perfecting 2% BHA Liquid ExfoliantTreatment

  Paula's Choice 2% BHA Liquid Exfoliant is the benchmark leave-on salicylic acid, with over 20 years of acne data behind it. It gets into pores to dissolve the plugs of dead skin and oil and stops new blackheads and whiteheads from forming. Its pH of 3.2-4.0 lets the salicylic acid work well. Use it in the morning or at night (not both), and not on the same night as a retinoid.

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• COSRX · BHA Blackhead Power LiquidTreatment

  COSRX BHA Blackhead Power Liquid is a water-based, willow-bark salicylic acid leave-on at a friendly price. It is a solid budget alternative to Paula's Choice. It is alcohol-free, so it tends to be easier on your skin than some others.

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• Differin · Adapalene Gel 0.1%Treatment

  Differin Adapalene Gel 0.1% is the only over-the-counter retinoid with trial proof as strong as prescription tretinoin. It clears clogged pores and keeps new ones from forming, and it is the gentlest retinoid (least irritating). AAD lists it as a first choice for mild to moderate acne. Put it on dry skin at night. Start every 2-3 nights and work up to nightly over 4-6 weeks.

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• The Ordinary · Retinol 0.5% in SqualaneTreatment

  The Ordinary Granactive Retinoid 2% or Retinol 0.5% is an affordable retinoid for anyone who wants to start gentle. There is less proof behind it than adapalene, but it works the same way to clear pores. It is a good pick if you are new to retinoids or want something for upkeep.

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• Naturium · Azelaic Topical Acid 10%Treatment

  Naturium Azelaic Topical Acid 10% is the best-proven over-the-counter azelaic acid we carry. It does three things at once: lowers the acne bacteria (C. acnes), calms inflammation, and fades the dark marks acne leaves behind. It is a good choice during pregnancy (no prescription needed), for mild to moderate inflamed acne on deeper skin tones where dark marks are a big concern, and as a backup when benzoyl peroxide or retinoids are too harsh for you.

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• COSRX · Acne Pimple Master Patch (24 ct)Treatment

  COSRX Acne Pimple Master Patch is a hydrocolloid spot sticker. It pulls fluid out of a pimple, covers it so you cannot pick at it or let germs in, and helps it heal faster. Hydrocolloid patches are the best-proven spot treatment you can buy. Use one overnight on a popped or weeping pimple.

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• The Ordinary · Niacinamide 10% + Zinc 1%Serum

  The Ordinary Niacinamide 10% + Zinc 1% does two jobs: the zinc cuts down oil, and the niacinamide fades the dark marks acne leaves behind. Safe morning and night. It plays well with every other active except pure vitamin C (using them together at high strength can cause brief flushing). Put it on before your moisturizer.

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• Skin1004 · Madagascar Centella AmpouleSerum

  SKIN1004 Madagascar Centella Asiatica Ampoule is concentrated centella that calms the pink-red marks left after a breakout and helps your skin barrier recover from benzoyl peroxide or retinoid irritation. Use it as a soothing layer between your treatments and your moisturizer.

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• Anua · Heartleaf 77% Soothing TonerToner

  Anua Heartleaf 77% Soothing Toner uses heartleaf (Houttuynia cordata) and panthenol to calm inflammation. It is alcohol-free and fragrance-free. It helps settle angry, inflamed pimples and the redness left after a breakout. It is a nice hydrating first step that will not get in the way of your other treatments.

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• The Ordinary · Hyaluronic Acid 2% + B5Serum

  The Ordinary Hyaluronic Acid 2% + B5 is a hydration layer that does not clog pores, which matters a lot if you use drying acne treatments. When benzoyl peroxide or strong salicylic acid strip your skin, it can react by making more oil. Adding this hydration helps prevent that. Put it on damp skin before your moisturizer.

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• CeraVe · PM Facial Moisturizing LotionMoisturizer

  CeraVe PM Facial Moisturizing Lotion combines ceramides, niacinamide, and hyaluronic acid in a light base that does not clog pores. It is the kind of moisturizer AAD recommends for acne-prone skin. It keeps your barrier healthy while you use retinoids and benzoyl peroxide, so the dryness does not make you quit. The light texture suits oily skin.

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• Beauty of Joseon · Relief Sun: Rice + Probiotics SPF 50+ PA++++SPF

  Beauty of Joseon Relief Sun Rice + Probiotics SPF 50+ PA++++ is a light sunscreen that suits acne-prone skin. It does not clog pores and does not feel greasy. Daily sunscreen is a must while you use retinoids, salicylic acid, or azelaic acid (all make your skin more sun-sensitive), and it keeps the sun from darkening the marks left after a breakout.

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• Round Lab · Birch Juice Moisturizing UV Lock Sunscreen SPF 45SPF

  Round Lab 1025 Dokdo Sunscreen SPF 45 PA+++ is a mineral sunscreen with birch sap in a hydrating, lightweight base. It suits acne-prone skin that cannot handle heavier sunscreens. It is fragrance-free.

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Ingredients to consider adding

Not yet in our catalog. Surfaced here as editorial backlog.

• Adapalene (0.1% / 0.3%)

  An FDA-approved retinoid (Differin 0.1% over the counter, Differin 0.3% by prescription). Among acne retinoids, it gives the best balance of working well and being easy to tolerate. In three large trials it cut inflamed pimples by 50-55% and clogged pores by 40-50% at 12 weeks compared with a plain base cream. Current AAD guidelines pick it as the first retinoid to try because it is gentler than tretinoin.

• Clindamycin (topical)Rx only

  A first-choice topical antibiotic for inflamed acne in AAD and European guidelines, but only when paired with benzoyl peroxide (combined products: Benzaclin, Duac, Acanya). Pairing it stops the acne bacteria (C. acnes) from becoming resistant. Using clindamycin on its own is no longer recommended. Always combine it with benzoyl peroxide.

• Dapsone (5% / 7.5% gel)Rx only

  An FDA-approved topical treatment for acne (Aczone). It calms inflammation in a different way than antibiotics, so there is no resistance worry. Two large trials show it clears a meaningful number of pimples at 12 weeks. The proof is especially good for adult women with acne.

• Spironolactone (oral, for female acne)Rx only

  A pill that blocks the hormone signals (androgens) telling your oil glands to make oil, so your skin makes less. It is the leading hormonal treatment for adult women with acne. AAD guidelines back it (Grade B), and several studies show 50-80% fewer inflamed pimples. It is a key option for hormonal acne, which a lot of general acne advice skips over.

• Isotretinoin (oral)Rx only

  The only acne treatment that hits all four causes of acne at once: it cuts oil by 70-80%, keeps pores from clogging, lowers the acne bacteria (C. acnes), and calms inflammation. It is the first choice for severe deep, cystic, or scarring acne, and the only treatment that can actually clear acne for good (about 85% of people stay clear after one course). In the US it requires registration in the iPLEDGE program because it causes serious birth defects. This is a treatment to ask a dermatologist about.

• Azelaic Acid (15% Rx)Rx only

  Finacea 15% gel and Azelex 20% cream are prescription strengths, higher than the 10% you can buy over the counter. Stepping up to 15-20% clears noticeably more pimples, and it is the strength tested in the trials against benzoyl peroxide and the antibiotic tetracycline.

• Clascoterone (Winlevi 1% cream)Rx only

  The first cream that blocks hormone signals in the skin, FDA-approved for acne in 2020 for ages 12 and up. It works right where you put it on the oil glands, without the body-wide hormone effects of a pill, so it is safe for men and women. Two large trials (SUNNY and CLARITY) showed clearer skin and fewer pimples at 12 weeks versus a plain base cream. It is a strong option for hormonal acne and acne driven by too much oil.

• Zinc Gluconate / Zinc Sulfate (oral)

  Several trials show taking zinc by mouth calms mild to moderate inflamed acne, though it does not work as well as oral antibiotics like tetracycline. It is a useful option if you cannot take antibiotics.