Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 5/18/2021
Whether you’re suffering from acne as a teen or an adult, the problem of facial breakouts and pimples is the same: blemishes can make us all self conscious and, over time, lower our self esteem.
Acne is a complicated problem with a multitude of solutions, some more effective than others.
But the one thing many of the best acne treatments out there have in common: they interact with the problem directly, as topical treatments.
We’re not saying pills and other therapies aren’t helpful — in fact, some of them can make or break your acne fight.
But some of the best treatments out there are applied directly to the problem skin before and during breakouts.
Before we talk about the various facial treatments on the market, we need to cover some basics about your skin and acne, so we can better explain how treatments work.
As simply as we can put it, acne is a bacterial infection that happens inside your pores.
Essentially, a combination of three things can turn a normally functioning pore into an acne hot spot.
Those three things are the oil your skin produces, the dead and dry cells sloughing off of your skin, your hydration level, and the population of naturally occurring bacteria living within your pores.
There are different kinds of acne, which occur depending on which element is most out of whack.
A build-up of cells is different from a clogged pore with thriving bacteria. The fact is that different kinds of blemishes have different severity levels that might require different solutions.
You can learn more about them at our Guide to the Types of Acne.
But the long and short of it is that you have to unclog, disinfect and get that pore back to full health.
As a treatment style, topicals are really effective for skin issues. We know facial treatments might present some concerns — the worst thing that can happen is further damage from a chemical burn or allergic reaction to make things look and feel even worse.
But there are a lot of safe and effective facial treatments out there.
Topical treatments come with advantages and disadvantages. The fact that they’re applied directly to the skin makes them both more effective and potentially more risky with regards to side effects.
The Journal Molecules published a comprehensive list of acne treatments in 2016, including a section on topical facial treatments that showed results.
They found the following list of treatments to be effective: retinoids, antibiotics, salicylic acid, alpha hydroxy acids, benzoyl peroxide, corticosteroids and several other less common treatments, like antiseptics, B vitamins, sulfur and hydrogen peroxide.
Here’s how it all breaks down:
Topical retinoids can be used for inflammatory acne, as a maintenance treatment, or to help reduce more severe acne.
Retinoids can also “repair the scarring and hyperpigmentation of skin.” They’re also largely considered a first-line treatment for most types of acne.
One of the most popular retinoids is tretinoin, which is a form of vitamin A. Tretinoin is effective for reducing dead skin cells that may block things up, and has been used safely for decades.
Tretinoin offers the double benefit of removing the dry, dead outer layer and, according to studies, boosting the younger skin’s growth underneath.
This can get your skin running fresh, healthy and regular again.
Tretinoin has also been shown to aid in collagen synthesis — which is a nice benefit if you’re concerned about the signs of aging.
Antibiotics are generally used for less intense outbreaks of inflammatory acne.
They’re used to undermine the acne bacterium itself, and when applied to the skin, they can help reduce the “stimulus for inflammation.”
Bacteria can become resistant to antibiotics over time and this has become the case with acne bacteria.
Salicylic acid is effective both as an anti-inflammatory and at reducing the buildup of dead skin cells that can contribute to blockages and acne outbreaks.
It’s also an effective antibacterial and antifungal. It’s available in over-the-counter products.
Chemical peels act similarly to vitamin A retinoids, but there isn’t a lot of evidence of them actually being safe.
According to some studies, it’s better to consider chemical peels a complementary treatment, instead of your first line of defense.
A topical disinfectant, benzoyl peroxide works as a peel and a bacteria killer. It kills the bacteria by releasing free radical oxygen, which “degrades the bacterial proteins.”
Benzoyl peroxide is effective for mild to moderate acne, and is best used at a different schedule than retinoids, because the two make each other less effective. Side effects may include burning, dryness, peeling or stinging.
There are other ways to treat acne of course, including addressing issues like skin hydration.
For this, many women look to herbal remedies — the kind of stuff you see on department store shelves.
For instance, aloe vera is frequently used as an ingredient. It’s not quite as effective as topical hyaluronic acid, which has been shown to help your skin retain skin moisture many times over its own mass.
And besides moisture, your lifestyle may be causing some of these problems. In addition to poor hydration, a high glycemic diet and general stress, have also both been shown to increase the risk of acne — not to mention diabetes and other serious conditions.
Take your health seriously, exercise, maintain a healthy diet and your body will have better tools and supplies for fighting acne (as well as a seemingly innumerable amount of other health issues and medical conditions).
Acne is a complicated problem, and each person’s acne can be as unique of a problem to solve as their fingerprints. As a result, this isn’t a DIY problem.
A healthcare provider should really be included in the acne-fighting process. They will be able to give you recommendations based on your acne type and skin type that will be more effective than the trial and error process of grabbing over-the-counter solutions yourself.