Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 6/20/2021
Acne is one of the most common skin diseases. In adolescence, it affects an estimated 79 percent to 95 percent of people.
For many people, acne breakouts continue into adulthood, with studies showing that up to 54 percent of women over 25 continue to experience facial acne.
While dealing with acne can be a frustrating experience for everyone, it can be particularly hard if you have sensitive skin that becomes red, irritated and inflamed easily.
Luckily, with the right combination of products, habits and information, it’s almost always possible to manage your acne breakouts without causing issues such as redness or skin irritation.
Below, we’ve explained how acne develops, as well as the factors that often contribute to acne breakouts.
We’ve also shared science-based treatments that you can use to treat, manage and stop acne breakouts, even if you have sensitive skin that’s easily irritated by most acne products.
Acne develops when the hair follicles in your skin, or pores, become blocked due to a combination of sebum and dead skin cells.
Sebum is an oil-like substance that’s secreted by your sebaceous glands. It plays an important role in maintaining your skin, both by sealing in moisture and by creating a protective barrier that shields your skin from environmental damage and harmful pathogens.
When your sebaceous glands secrete too much sebum, it can form plugs inside your pores that eventually develop into whiteheads, blackheads and other common acne lesions.
The second component in acne — dead skin cells — form as a result of your skin’s natural process for repairing and rejuvenating itself.
Your epidermis — the outermost layer of your skin — replaces old cells with new ones every 40 days to 56 days through a process called epidermal turnover.
As a byproduct of this process, dead skin cells can build up on the surface of your skin. When these cells mix with sebum, they can contribute to blocked pores and acne breakouts.
However, when bacteria multiply inside a clogged pore, it can cause acne to become infected, inflamed and painful.
Common forms of inflamed acne include papules, pustules and cystic or nodulocystic acne.
Most acne treatments, including acne treatments designed for sensitive skin, work by targeting one or several of the causes of acne: sebum, dead skin cells or bacteria.
Others work by targeting factors that contribute to acne breakouts, such as your levels of certain hormones.
When you have sensitive skin, treating acne is all about targeting the factors that contribute to it, without causing your skin to become excessively dry, red or irritated.
It’s also about actively avoiding the habits, behaviors and products that can actually make acne worse.
Striking this balance isn’t always easy.
This is because many of the most effective treatments for acne can also cause issues like dryness, flaking and irritation, especially when they’re applied to your skin often or in a high-strength product.
However, with the right approach, it’s possible to treat acne using science-based medications, even if your skin is sensitive.
Below, we’ve listed five acne treatments that are worth looking into if you have sensitive skin, as well as tips and techniques to clear away acne while avoiding common side effects.
Topical retinoids are medications derived from vitamin A. They work by increasing the speed at which your skin sheds old, dead cells and replaces them with new ones.
By doing this, retinoids lower the risk of dead skin cells collecting inside your pores and causing acne breakouts.
They also provide other benefits, such as making fine lines, wrinkles and other common skin imperfections less visible.
Retinoids have been in use for decades and are very common as treatments for acne.
Thanks to their effectiveness, availability and key role in acne treatment, they’ve been referred to as the “mainstay” of therapy for acne in scientific research.
Several retinoids are used as acne treatments, including the medications retinol, adapalene and tretinoin.
Retinol and adapalene are both available over the counter. You can find retinol in many creams, masks and other over-the-counter acne treatments, while adapalene is used as an ingredient in topical acne treatments like Differin® gel.
Tretinoin is a more powerful retinoid that’s sold as a prescription medication. It’s available in our Prescription Acne Cream.
Retinoids — tretinoin, in particular — are very effective at treating acne. However, they can cause side effects, some of which might be irritating if you have sensitive skin.
For example, topical tretinoin is known to sometimes cause redness, dryness, stinging, peeling and scaling, flaky skin, especially during the first few weeks of treatment.
To get the best of retinoids without the worst, you’ll want to start with a mild retinoid.
Check your local drugstore for creams, masks and cleansers that contain retinol, which is generally safe and non-irritating.
If you’d prefer to use a more powerful retinoid, you may want to consider treatments that contain adapalene or tretinoin.
These retinoids are more likely to cause irritation. However, you may be able to reduce your risk of side effects by choosing low-strength products (for example, 0.025% tretinoin instead of 0.1% tretinoin), or by applying products that contain retinoids every other day.
Another option is to wash away retinoid-based topical treatments after one to two hours, instead of leaving them on overnight.
Our guide to topical retinoids for acne provides more information on how these ingredients work, their effects, potential side effects and more.
Benzoyl peroxide is a popular over-the-counter acne medication.
It’s a widely used ingredient in cleansers, creams and gels, and works by stopping harmful, acne-causing bacteria from growing on your skin.
Like many other acne treatments, benzoyl peroxide can potentially cause side effects, including dryness, stinging, tingling and peeling.
These can be an issue if you have sensitive skin. However, you can reduce your risk of dealing with side effects from benzoyl peroxide in a few ways.
The first is to use a benzoyl peroxide cleanser instead of a leave-on mask.
Apply your acne cleanser in the shower, then wash it off relatively quickly.
This will help to wash away excess sebum and dead skin cells without drying out your skin too much.
The second is to moisturize, moisturize, moisturize. After you shower, try to apply moisturizer to your face as soon as possible to lock in moisture and prevent it from feeling brittle and flaky.
Exfoliants, such as alpha-hydroxy acids and beta-hydroxy acids, work by removing the layer of dead skin cells that can accumulate on your face and contribute to acne breakouts.
Common exfoliants include salicylic acid, azelaic acid, citric acid, glycolic acid, tartaric acid and others.
You can find many of these as active ingredients in cleansers, toners, peels, masks and other topical acne treatments.
Like other acne treatments, many exfoliants can cause dryness, stinging and skin irritation.
You can reduce your risk of experiencing these side effects by using a mild exfoliating cleanser and washing it off shortly after you apply it.
If you notice your skin becoming dry or flaky, try taking one day off between washes to give your skin time to recover.
When you’re comparing exfoliants, look for products labeled “mild” or “for sensitive skin.” These are often formulated to be less irritating and more suitable for sensitive skin.
Topical antibiotics work by preventing acne-causing bacteria such as Propionibacterium acnes (P. acnes) from growing on your skin.
One of the most common topical antibiotics for treating acne is clindamycin, which both inhibits bacterial growth and controls swelling. Clindamycin is one of several active ingredients in our prescription acne cream.
Your healthcare provider may prescribe a topical antibiotic if you have inflamed, infected acne, such as papules, pustules or cystic acne.
Currently, the FDA has approved three birth control pills — Yaz®, Estrostep® and Ortho Tri-Cyclen®, as well as their generic equivalents — as treatments for acne.
These pills work by reducing your levels of hormones that can stimulate sebum production and make your skin oily.
Although birth control pills can cause side effects, it’s a safe option for most women that rarely causes dry skin, itching or irritation.
We’ve talked about this form of acne treatment in more detail in our full guide to birth control and acne.
If you have sensitive skin, it’s important to take extra care when using acne treatments to avoid irritating your skin.
Use the following techniques to take care of your skin and lower your risk of dealing with side effects:
If your skin is sensitive and easily irritated, don’t rush into treating acne by using the most powerful products available.
Instead, start slow with the mildest versions of common acne treatments (for example, .01% or .025% tretinoin cream).
This allows you to check your skin’s reaction to an acne treatment before you increase the strength or use it more frequently.
Washing your skin excessively can irritate your skin, making acne breakouts worse.
According to the American Academy of Dermatology, it’s best to wash your face twice a day — once in the morning and again before bed.
It’s also important to wash your face after you exercise or do anything else that causes you to sweat.
If you notice that your skin becomes red, itchy or uncomfortable after using acne medication on a daily basis, try to scale your use back to once every other day, or even once every three days.
When you apply exfoliants or other products to your skin, use your fingertips rather than a washcloth and apply the products gently in a circular motion.
After you finish, gently dry your skin using a clean towel.
Many acne treatments, such as benzoyl peroxide, adapalene, salicylic acid and tretinoin, can dry out your skin and cause irritation.
If your skin feels dry, make sure to apply moisturizer as soon as you can to prevent it from drying out excessively.
Lots of cosmetics, moisturizers and other skin products are comedogenic, meaning they’re made using oils and other ingredients that can block pores and cause acne breakouts.
When you’re shopping for makeup and skin care products, look for items that are labeled “non-comedogenic” or “oil-free.”
These are designed to prevent clogged pores and lower your risk of developing acne.
Many acne treatments, including topical retinoids, can make your skin more sensitive to the sun.
Make sure to apply a water-resistant, SPF 30+ sunscreen when you spend time outdoors on sunny days.
More acne treatments doesn’t necessarily mean better results, especially if you have sensitive skin that’s prone to redness, peeling and other issues.
Keep your skin care routine simple and avoid using too many treatments at once.
Try to stick with one or two products, at least to get started, then adjust your routine based on how your skin responds.
Although sensitive skin and acne can be a frustrating combination, it’s usually possible to treat acne without irritating your skin with the right mix of medication and healthy habits.
You can learn more about getting rid of your acne for good in our detailed guide to preventing acne breakouts.