Best Over the Counter Acne Treatments in 2021

Making a sound over-the-counter acne product selection can be difficult, if not impossible unless you’re fully informed of the ingredients to look for, to ensure minimal trial and error. 

When you wake up with a new blackhead, whitehead, or pimple, you need to know you have an effective acne-fighting solution in your skincare routine. 

Finding the holy grail of spot treatment or all-over acne breakout solution at the drugstore may take some time. Knowing the best active ingredient to treat blemishes is a good place to start.

Background on Acne in Adult Females

First, let’s get something out of the way: you’re not abnormal because you’re still struggling with acne. Adult female acne is not uncommon. 

In fact, it’s more common in women than men, and about one-third of all dermatology visits are made by women over the age of 25. 

No matter the age, acne is caused by a collection of factors, including: excess oil (sebum) production, the Propionibacterium acnes or P. acnes bacteria and dead skin cells that clog pores. 

These things can be influenced by numerous factors, including your diet, hormones, and skin care routine.

When it comes to acne triggers, hormones are a biggy for most women. As much as 85 percent of adult women say they have worsening acne before their periods. 

And women who deal with conditions like polycystic ovarian syndrome (PCOS) can have a particularly rough time with hormonal acne.

OTC vs Prescription Acne Treatments 

Before seeking out prescription solutions from a dermatologist, such an oral antibacterial acne medication, many people with acne consider giving over-the-counter skin care products a shot. 

While prescription acne treatments are readily available and there are many your doctor can prescribe, OTC treatments can sometimes seem more convenient than seeing a healthcare professional.

However, for those with stubborn, moderate, severe or cystic acne, a severe form of acne that is difficult to treat and forms deep within the skin, a prescription acne treatment may be the right option. 

Even if your acne is relatively mild, having a healthcare professional look at your acne and medical history can help you find the right treatment without trying all the acne treatment options on the drugstore shelves.

Active Ingredients to Look For in OTC Acne Treatments

While perusing the drugstore aisles, it is a good idea to check labels before purchasing an over the counter acne treatment product. 

It is important to put non-comedogenic (non clogging) ingredients on your shopping list, but you will also want to look for some key acne-busting active ingredients. Here are a few things to look for:

Benzoyl Peroxide 

Benzoyl peroxide is a topical medication that prevents the clogging of pores (comedolytic) and fights the bacteria that causes acne.  Some evidence suggests this ingredient is more effective in women than men. 

Research has found that it can reduce acne lesions, or pimples, by as much as 65 percent in women with moderate-to-severe acne.

However, benzoyl peroxide can cause increased dryness in mixed or dry skin types. This can cause skin irritation, which may make it a tough ingredient to stick with. 

This generally isn’t a problem if you have very oily skin, but could become more difficult to manage if you have sensitive skin or your skin is drying with age. 

In general, keeping your over-the-counter products to no more than 5% benzoyl peroxide concentration may minimize this side effect. 

Also, be warned, benzoyl peroxide can bleach fabrics. Your pillowcases, towels, and anything else you touch your face with after applying could wind up with bleach spots -- a small price to pay for acne-free living.

Topical Retinoids 

Prior to 2016, topical retinoids were only available via prescription for the treatment of acne. However, the Food and Drug Administration changed that when they announced the availability of adapalene (a 0.1% retinoid) over the counter.

Initially only sold under the brand name Differin® — which has been around since 1996 — there are now other brand name adapalene products available without a prescription. 

Higher concentrations of adapalene must be obtained with a prescription, but this lower concentrated formula may be an effective, easily available option.

One meta-analysis of a few clinical trials found that combining adapalene 0.1% with benzoyl peroxide 2.5% resulted in about a 70 percent reduction in acne lesions.

Salicylic Acid 

Salicylic acid is another popular over-the-counter ingredient to treat acne prone skin. It’s known as a beta-hydroxy acid and can be found in a variety of products including cleansers and lotions. 

Like benzoyl peroxide, it works to prevent clogged pores. It does this by breaking the bonds between cells on the outermost layer of skin (stratum corneum). 

Salicylic acid can cause skin irritation and peeling, depending on the formula and concentration. 

Over-the-counter formulas generally have 0.05% to 5% salicylic acid concentration, so if you experience irritation at the higher end, you may want to look for products with less concentrated acid.

Get the latest on treating acne with salicylic acid.

Azelaic Acid

Azelaic acid can be found in numerous over-the-counter formulas or in higher concentrations by prescription. 

While it’s slightly less common than the previously mentioned ingredients, there is evidence that this ingredient shows similar efficacy, particularly in the treatment of mild-to-moderate acne. 

Hyaluronic Acid

Hyaluronic acid can be found in many acne face creams and ointments, and can be used to improve the overall moisture of the skin. This is because it is a natural substance that your body uses to lubricate and moisturize your skin and connective tissues. 

While hyaluronic acid does not directly fight acne-causing bacteria or help with cell turnover like retinoids, it can help your skin stay hydrated, which is key to prevent acne caused by skin dryness. 

In addition, because it is naturally generated by your body, hyaluronic acid is generally well-tolerated and is great for sensitive skin.

Glycolic Acid

Often used as an ingredient in face masks and peels, glycolic acid is an alpha hydroxy acid that chemically exfoliates and peels away the top most layer of the skin. 

This can help lead to a clearer complexion, less inflammatory acne, and a decrease in hyperpigmentation.

Natural Ingredients 

While looking to avoid chemicals, some people seek out so-called natural ingredients to ward off zits and pimples. 

While clinical research and evidence of effectiveness is very thin, the following ingredients are commonly used in OTC acne treatments for acne-fighting or anti-inflammatory properties : 

• tea tree oil

• vitamin a

• aloe vera 

• green tea

• zinc

• jojoba oil

Over-the-Counter Acne Treatments in Combination

Often, a dermatologist will recommend combination treatments for adult acne in women.

For example, while benzoyl peroxide can be bought and used alone, its effects are said to be enhanced when used with prescription topical therapies such as erythromycin or tretinoin for acne.

Other Skin Care Tips

In order to keep your face clear of cysts, whiteheads, blackheads, or any other acne that may creep up, it is important to establish a good skin care routine for acne. 

Try to incorporate these steps into your day-to-day skin care: 

• wear sunscreen with an SPF of 30 or higher

• use a gentle face wash twice a day

• use an oil free moisturizer after washing

• consider occasional exfoliating to rid your skin of built up dead cells and increase cell turnover

The Bottom Line on OTC Acne Treatments 

There are numerous products on the shelves and online for the treatment of acne, and while the variety is great, it makes it difficult to choose. 

Looking for ingredients such as benzoyl peroxide, which is backed with scientific research and years of use, can help ensure you’re not wasting your money on the next hot thing. 

If you find an OTC product isn’t cutting it for your acne breakouts, talk to a hers certified medical professional about a custom prescription acne treatment.