20 Best Acne Treatments in 2021 - Healthline

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The cause of acne usually boils down to clogged pores when a mix of sebum, bacteria, and dead skin cells are trapped in a hair follicle.

Each pore on the surface of skin is the opening to a hair follicle, which is made up of a hair and an oil gland. When working properly, the oil gland releases sebum that travels up the hair and out of the pore. The sebum reaches the skin, where its job is to keep skin lubricated.

If part of this process goes awry, acne may occur.

This can be due to excessive sebum produced by the oil gland, a buildup of dead skin cells, or the accumulation of bacteria — all of which can lead to clogged pores that contribute to the formulation of acne.

Determining the best acne treatment for you depends on the type of acne and severity.

“The best way to determine the right acne treatment plan is to see a dermatology provider,” explains Julie C. Harper, MD, a board certified dermatologist and clinical associate professor of dermatology at the University of Alabama-Birmingham. “There are many different types of acne, and treatment regimens vary from person to person.”

A dermatologist will closely examine your skin to see which of the different types of lesions appear:

• Mild noninflammatory acne (aka comedonal acne) includes whiteheads and blackheads.
• Moderate inflammatory acne includes papules and pustules.
• Severe inflammatory acne includes nodules and cysts.

Noninflammatory acne can usually be cleared up with OTC products containing active ingredients like salicylic acid and benzoyl peroxide, or prescription-strength topical retinoids.

Inflammatory acne requires topical or oral prescriptions from a dermatologist to effectively treat.

Though papules and pustules may clear up with OTC products alone, inflammatory acne is more likely to lead to scarring, so seeing a dermatologist is the best way to clear acne and prevent acne scars.

The acne treatments on this list are based on:

• recommendations from board certified dermatologists
• ingredients proven to be effective in treating acne
• customer reviews

Pricing guide

• $ = under $20
• $$ = $20–$30
• $$$ = over $30

Note: Some picks below do not list price since they are prescriptions, and the price will vary substantially based on healthcare access and insurance.

1. Tretinoin

• Product type: Topical cream or gel
• Prescription: Yes
• Type of acne: Noninflammatory acne

Tretinoin is a prescription-strength topical cream or gel. Like retinol, tretinoin is a retinoid derived from vitamin A. It works by speeding up the life cycle of skin cells. It makes them divide and die faster so newer, healthier skin cells can come to the surface.

This is beneficial not only for treating acne, but also for improving the appearance of fine lines and wrinkles.

“Tretinoin helps soften the clog and push it to the surface while exfoliating,” says Susan Bard, MD, a board certified dermatologist in New York. “It also prevents the pore from reclogging once it’s cleared out. Retinoids like tretinoin are best suited for comedonal (aka clogged pore) acne.”

To get a prescription for tretinoin, you’ll need to visit a doctor’s office, like a dermatologist, or communicate with one virtually through online services like Curology or Hers.

2. Tazorac

• Product type: Topical cream or gel
• Prescription: Yes
• Type of acne: Noninflammatory acne and moderate inflammatory acne

Depending on the severity of the acne, a gel or cream called Tazorac may be prescribed. Tazorac contains the active ingredient tazarotene. It’s a retinoid that’s usually prescribed at 0.1 percent strength for acne.

Tazorac gel is recommended for mild to moderate breakouts on the face. Tazorac cream may be prescribed for some severe cases, such as cystic acne or acne on other areas of the body.

“Tazarotene, another type of retinoid like tretinoin, works to treat acne by slowing skin cell overgrowth and preventing a buildup of dead skin cells on the surface,” Bard explains. “It also reduces skin inflammation and has been shown to reduce the number of inflammatory lesions.”

You can purchase Tazorac with a prescription through services like GoodRx, or at locations such as CVS and Walgreens.

3. Altreno

• Product type: Topical lotion
• Prescription: Yes
• Type of acne: Noninflammatory acne

Joshua Zeichner, MD, FAAD, a board certified dermatologist and the director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City, recommends Altreno for adults with comedonal acne.

Altreno contains tretinoin, a retinoid that’s commonly prescribed to treat acne. Unlike other tretinoin prescription medications, which usually take the form of a topical cream or gel, Altreno is a lightweight lotion that targets breakouts while moisturizing skin.

“Topical retinoids are a foundational treatment for acne,” says Zeichner of the significance of tretinoin in Altreno. “They work like pipe cleaners to keep your pores open. Retinoids prevent cells from sticking together and blocking the pores, trapping oil within them. They also help enhance cell turnover to even skin tone and texture.”

4. Oral contraceptives

• Product type: Oral pills
• Prescription: Yes
• Type of acne: Hormonal acne

Though not its main function, combination birth control pills can be prescribed as part of an acne treatment in female patients.

Oral contraceptives contain hormones that decrease the circulation of androgens, thereby decreasing the production of sebum. This helps regulate oily skin and make acne-prone skin more manageable.

According to Zeichner, “Oral contraceptive pills cannot only be used to prevent pregnancy, but there are four pills that are FDA-approved to treat acne. They work by regulating hormones that stimulate oil glands.”

The oral contraceptive pills that have been approved by the Food and Drug Administration (FDA) for use in the treatment of acne include:

• Beyaz
• Estrostep Fe
• Ortho Tri-Cyclen
• Yaz

Dermatologists may prescribe one of these birth control pills to manage hormonal acne that occurs due to hormone fluctuations.

You may purchase birth control pills online through services like Nurx and The Pill Club.

5. INNBeauty Project Pimple Paste

• Price: $
• Product type: Spot treatment
• Prescription: No
• Type of acne: Inflammatory acne

This spot treatment for acne comes recommended by Zeichner, who emphasizes the effectiveness of sulfur in acne products: “Sulfur-based products are available both over the counter and by prescription. They have anti-inflammatory and antimicrobial properties to help lower inflammation in the skin.”

Instead of drying out acne with toothpaste, which can contain ingredients that are too harsh for skin, this paste contains active ingredients proven to combat breakouts, including sulfur, azelaic acid, and tea tree oil.

It also contains witch hazel, which is commonly used in home remedies for acne.

Apply overnight as a spot treatment and rinse away in the morning. This paste should not be used as an all-over treatment, but it can be applied in a thin layer to larger clusters of lesions.

6. Hers Prescription Acne Cream

• Product type: Topical cream
• Prescription: Yes
• Type of acne: Noninflammatory acne to moderate inflammatory acne

This prescription acne cream for adults is powered by a customized blend of five active ingredients that target acne:

• tretinoin
• clindamycin
• azelaic acid
• zinc pyrithione
• niacinamide

“Tretinoin is a topical retinoid and is an important component of an acne regimen because it increases cell turnover, makes dead skin cells less likely to stick together and clog up pores, and decreases discoloration,” says Hadley King, MD.

Though Hers Acne Cream requires a prescription, you never have to step foot in a dermatologist’s office to get evaluated and begin treatment.

People with acne can seek treatment from home by answering some questions about their skin, consulting with a licensed medical provider, and receiving a personalized acne cream tailored to their needs.

7. Hers Custom Acne Treatment for Teens

• Product type: Topical cream
• Prescription: Yes
• Type of acne: Noninflammatory acne to moderate inflammatory acne

Acne is extremely common in teens, but a prescription acne treatment may help. Like the Hers Acne Cream for adults, the Hers Acne Treatment for Teens is formulated with a custom combination of:

• tretinoin
• clindamycin
• azelaic acid
• zinc pyrithione
• niacinamide

King explains that “topical clindamycin is an antibiotic and can help decrease bacteria that contribute to acne, while niacinamide is helpful for tone and texture. [It is] less likely to be irritating to the skin compared to some other formulations.”

With a guardian’s consent, teens under 18 are given an opportunity to talk with a skin expert online about their specific type of acne and concerns. If prescribed, teens’ custom acne formula is shipped right to their door.

8. Differin Gel

• Price: $
• Product type: Topical gel
• Prescription: No
• Type of acne: All

The main acne-fighting ingredient in Differin is 0.1 percent adapalene, which was formerly only available with a prescription. Now this prescription-strength retinoid is available OTC.

Since it’s widely available, affordable, and suitable for all types of acne, Differin Gel may be beneficial for many people with acne.

Differin Gel comes recommended by Dina Strachan, MD, a board certified dermatologist in New York and assistant clinical professor at New York University.

“Retinoids treat acne by helping to unplug the hair follicle where acne starts. They also help with exfoliation that can help with the blemishes or hyperpigmentation left by acne lesions,” Strachan says.

“Some retinoids even directly reduce inflammation. Retinoids are a cornerstone treatment for all acne patients, especially patients with dark skin with hyperpigmentation,” she adds.

9. Neutrogena Oil-Free Acne Wash Cream Cleanser

• Price: $
• Product type: Cleanser
• Prescription: No
• Type of acne: Noninflammatory acne

A list of the best acne treatments wouldn’t be complete without a salicylic acid face wash for acne.

Strachan recommends this Neutrogena cleanser for acne since it contains salicylic acid.

“Salicylic acid is lipophilic, meaning it loves fat, which attracts it to the oily hair follicle where acne begins,” Strachan says. “Like retinoids, it unplugs the hair follicle, exfoliates, and reduces inflammation. Salicylic acid can be helpful for all types of acne.”

Salicylic acid is a go-to OTC ingredient for acne since it dissolves the dead skin cells in clogged pores, helping to treat existing acne and prevent future breakouts.

Some customers note that this cleanser results in dry skin after use, so following up with a moisturizer suitable for acne-prone skin is recommended.

10. AKLIEF (trifarotene) Cream

• Product type: Topical cream
• Prescription: Yes
• Type of acne: Inflammatory acne on the face and body

If you experience inflammatory acne, especially on the chest, back, and shoulders, your dermatologist may prescribe AKLIEF Cream.

The active ingredient in AKLIEF is 0.005 percent trifarotene, a retinoid that removes dead skin cells from the surface, prevents new acne from forming, and reduces skin inflammation.

According to board certified dermatologist Christine Choi Kim, MD, FAAD, who recommends AKLIEF for face and body acne, trifarotene “is a unique topical retinoid that selectively targets the retinoic acid receptor (RAR) gamma, the most common RAR found in the skin. It has been proven effective on facial acne as well as chest, shoulders, and back acne.”

11. Yes To Tomatoes Charcoal Facial Cleanser

• Price: $
• Product type: Cleanser
• Prescription: No
• Type of acne: Noninflammatory acne

People who experience blackheads and whiteheads may be able to clear it up with just OTC skin care products like this Yes To Tomatoes cleanser.

Aware that there’s a sea of cleansers for acne-prone skin, Kim recommends this cleanser because it “combines three beneficial ingredients: charcoal to naturally detoxify impurities and deep clean your skin, tomato extract to deliver antioxidants, and salicylic acid to help decongest whiteheads and blackheads.”

Kim also recommends leaving this cleanser in the shower for use all over the body for people prone to breakouts on the chest, shoulders, and back.

Though it’s designed for facial use, the ingredients may also be beneficial for clearing up body acne. Some users report sensitivity, however, since this cleanser contains alcohol and fragrance.

12. Oral antibiotics

• Product type: Oral pills
• Prescription: Yes
• Type of acne: Inflammatory acne

Harper recommends prescription oral antibiotics, such as sarecycline or minocycline, for widespread or more severe cases of acne.

“Sarecycline is a prescription oral antibiotic indicated for the treatment of inflammatory lesions of non-nodular moderate to severe acne vulgaris,” Harper says. “It is effective against Cutibacterium acnes, the bacteria involved in the pathogenesis of acne, and it is anti-inflammatory.”

She also notes that sarecycline has less effect on the gut than other oral antibiotics.

Harper also recommends minocycline, a prescription oral antibiotic, for inflammatory acne. It’s also available as a topical prescription, which may have fewer potential systemic side effects.

You may purchase these types of oral antibiotics with a prescription at pharmacies such as CVS, Walgreens, and through services like GoodRx and Nurx.

13. Spironolactone

• Product type: Oral pills
• Prescription: Yes
• Type of acne: Inflammatory acne

In addition to oral medications like birth control and antibiotics, other oral medications may improve acne. Spironolactone is used to treat high blood pressure and heart failure, but it can also treat acne.

According to Brooke Grant Jeffy, MD, FAAD, a board certified dermatologist in Arizona, “Spironolactone is an oral medication that can improve all forms of acne but is primarily used for more inflammatory acne, or acne that is hormonal in nature in women.”

“Androgen type hormones, such as testosterone, contribute to acne formation by increasing sebum production by oil glands in the skin,” Jeffy says.

“Spironolactone interferes with the ability of androgen hormones to cause excessive sebum production by decreasing production of these hormones and preventing them from working on their target receptors,” she adds.

Spironolactone may be purchased with a prescription at pharmacies such as CVS and Walgreens, and through services such as GoodRx.

14. The Ordinary Azelaic Acid Suspension 10%

• Price: $
• Product type: Topical cream-gel
• Prescription: No
• Type of acne: Noninflammatory acne to moderate inflammatory acne

Azelaic acid is available in some OTC skin care products in smaller amounts. It works by clearing the pores of bacteria, which is usually the cause of acne, and reducing skin inflammation associated with acne.

The Ordinary Azelaic Acid Suspension 10% is a lightweight cream-gel that targets acne and uneven skin tone and texture. It can reduce the number of blemishes and minimize the appearance of acne scars.

Some users report that the formula is effective on active breakouts but can result in pilling. That’s when a product sits on top of the skin’s surface and collects in flakes or balls of product.

Robin Evans, MD, a board certified dermatologist in Connecticut, recommends this product since the key ingredient, azelaic acid, is “helpful for the pimple aspect of acne and for hyperpigmentation that can be the result of blemishes. It is available at higher strength as a prescription, which would be even more effective.”

15. Paula’s Choice SKIN PERFECTING 2% BHA Liquid Exfoliant

• Price: $$
• Product type: Exfoliant
• Prescription: No
• Type of acne: Noninflammatory acne

Evans generally recommends some form of topical medication or skin care for all people with acne, including skin care products that contain salicylic acid, which targets the inflammatory component of acne.

She approves this award-winning BHA exfoliant by Paula’s Choice for comedonal acne like whiteheads and blackheads.

While salicylic acid is usually formulated in cleansers, this exfoliant is a leave-on product that sheds built-up layers of skin. It has a lightweight texture that’s designed to absorb quickly and can be applied with a cotton pad or fingers.

Since this formula is gentle, it may be ideal for people with acne who are new to exfoliating with BHAs. It can also be used up to twice a day in your morning and evening skin care routine.

However, starting slowly is recommended. Salicylic acid may increase sensitivity to the sun, so daytime applications should be followed up with SPF.

16. Mario Badescu Drying Lotion

• Price: $
• Product type: Spot treatment
• Prescription: No
• Type of acne: Noninflammatory acne and inflammatory acne

A spot treatment can be an effective part of improving acne. Drying formulas dry up active breakouts and draw out impurities from the skin, which are more beneficial for treating current acne than preventing future breakouts.

Evans notes that OTC skin care products containing active ingredients like sulfur and salicylic acid can be helpful in treating acne. This award-winning spot treatment by Mario Badescu contains both.

To apply, avoid shaking the bottle. Separation in the formula is expected. Dip a clean cotton swab into the sediment at the bottom of the bottle. Dab directly on the blemish, don’t rub. Let dry overnight and rinse in the morning.

17. Clindamycin phosphate

• Product type: Topical gel or lotion
• Prescription: Yes
• Type of acne: Inflammatory acne

Both oral and topical antibiotics may be prescribed for more severe types of acne. According to Zain Husain, MD, FAAD, a board certified dermatologist in New Jersey, clindamycin phosphate is a “topical antibiotic that is highly effective in killing bacteria and reducing inflammation. It is suitable for inflammatory and cystic acne.”

Clindamycin phosphate works by stopping the growth of acne-causing bacteria on the skin. This results in fewer acne lesions over time. In more severe cases of acne, your dermatologist may prescribe 1 percent clindamycin phosphate gel or lotion.

You may purchase clindamycin phosphate with a prescription at pharmacies like CVS and Walgreens, and through services like GoodRx.

18. La Roche-Posay Effaclar Duo Dual Acne Treatment

• Price: $$
• Product type: Spot treatment
• Prescription: No
• Type of acne: Inflammatory acne

Cystic acne is an especially uncomfortable form of inflammatory acne. It’s characterized by deep, pus-filled pimples that may be red and painful.

Husain approves this La Roche-Posay spot treatment since the key ingredient, benzoyl peroxide, “helps to kill bacteria and reduce inflammation, which is well suited for inflammatory and cystic acne.”

While benzoyl peroxide has been a proven contender against inflammatory acne, OTC spot treatments alone may not clear up cystic acne entirely. In conjunction with dermatologist visits, products containing benzoyl peroxide can be an effective part in treating acne.

19. SkinCeuticals Purifying Cleanser Gel

• Price: $$$
• Product type: Cleanser
• Prescription: No
• Type of acne: Noninflammatory acne and inflammatory acne

Derived from sugarcane, glycolic acid is a chemical exfoliant that weakens the bonds that hold together dead skin cells, which can clog pores. This may result in fewer skin cells since there are less skin cells on the surface that can end up in hair follicles.

“Glycolic acid is an alpha hydroxy acid used for chemical exfoliation, reducing sebum, and brightening hyperpigmentation from prior acne. It is also effective for comedonal acne as well as inflammatory and cystic acne,” says Husain of this SkinCeuticals cleanser.

Glycolic acid is available in a variety of OTC product types, including cleansers, serums, moisturizers, and more.

Since cleansing is an important part of managing skin that’s prone to acne, glycolic acid cleansers can serve multiple purposes: cleansing away impurities and exfoliating away dead skin cells.

20. Isotretinoin

• Product type: Oral pills
• Prescription: Yes
• Type of acne: Inflammatory acne

“Those with moderate to severe cystic acne or acne that hasn’t responded to other treatments may benefit from isotretinoin, also known as Accutane, a derivative of vitamin A,” Husain says. “It is a very potent medication that is highly effective in treating nearly all types of breakouts. It works by decreasing oil production that can lead to the formation of acne.”

While isotretinoin isn’t usually the first course of action when it comes to treating acne, it may be necessary for severe cases where other treatments haven’t been effective. Isotretinoin is an oral prescription that’s usually taken twice daily.

Since isotretinoin is associated with serious side effects, it should only be used as advised by a medical professional.

You may purchase isotretinoin with a prescription at pharmacies like CVS and Walgreens, and through services like GoodRx.

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