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Over-the-counter acne products: What works and why

Many acne products are available in pharmacies and drugstores. Find out how they differ, what main ingredients to look for and how to use these products for best results.

By Mayo Clinic staff

Many over-the-counter (OTC) acne products are available to treat mild to moderate acne or periodic breakouts. But with so many acne products lining store shelves, how do you know which one is best for you?

Before you grab whatever package is closest, learn how OTC acne products work and what ingredients to look for. Then, develop a gentle skin care regimen to treat and prevent acne breakouts.

Active ingredients in acne products

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Image showing how acne develops 
How acne develops

Acne products work in different ways, depending on their active ingredient. Some OTC acne products work by killing the bacteria that cause acne inflammation. Other acne products remove excess oils from the skin or speed up the growth of new skin cells and the removal of dead skin cells. And in some cases, acne products work by doing a combination of these things.

Here are common active ingredients found in acne products and how they work to treat acne.

  • Benzoyl peroxide. Used in both OTC and prescription acne products, benzoyl peroxide kills the bacteria that cause acne, helps remove excess oils from the skin and removes dead skin cells that clog pores. Available in strengths from 2.5 to 10 percent, benzoyl peroxide can cause excessive dryness, scaling, redness, burning and stinging, especially if you have sensitive skin. Be careful when applying benzoyl peroxide, as it can bleach hair and clothing.
  • Salicylic acid. This ingredient slows shedding of cells inside the hair follicles, which prevents the pores from clogging. Salicylic acid can cause mild stinging and skin irritation. OTC acne products are available with 0.5 to 2 percent salicylic acid.
  • Alpha hydroxy acids. Glycolic acid and lactic acid are two types of alpha hydroxy acids that are used in OTC acne products. They're synthetic versions of acids derived from sugar-containing fruits. They treat acne by helping to remove dead skin cells and helping to reduce inflammation. Alpha hydroxy acids also stimulate the growth of new, smoother skin, which helps reduce the appearance of acne scars.
  • Sulfur. Often combined with other ingredients, such as salicylic acid, benzoyl peroxide or resorcinol, sulfur removes dead skin cells that clog pores and helps remove excess oil. Products containing sulfur may cause dry skin, and some products have an unpleasant odor.
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References
  1. Bowe WP, et al. Effective over-the-counter acne treatments. Seminars in Cutaneous Medicine and Surgery. 2008;27:170.
  2. Graber E. Treatment of acne vulgaris. http://www.uptodate.com/index. Accessed May 2, 2012.
  3. Dover JS, et al. Light-based, adjunctive and other therapies for acne vulgaris. http://www.uptodate.com/index. Accessed May 2, 2012.
  4. Acne treatment available without a prescription. American Academy of Dermatology. http://www.skincarephysicians.com/acnenet/treatotc.html. Accessed May 2, 2012.
  5. Ramanathan S, et al. Management of acne vulgaris. Journal of Pediatric Health Care. 2011;25:332.
  6. Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, U.K.; New York, N.Y.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7234-3541-9..X0001-6--TOP&isbn=978-0-7234-3541-9&uniqId=230100505-57. Accessed May 2, 2012.
  7. Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. May 11, 2012.
SN00039 July 18, 2012

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