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What Are the Best Over-the-Counter Options for Acne?

Patricia Pinto-Garcia, MD, MPHMaria Robinson, MD, MBA
Updated on April 4, 2023

Key takeaways:

  • Evidence shows that over-the-counter (OTC) acne medications can fight acne and keep it from coming back.

  • Some of the best OTC acne treatments are adapalene, benzoyl peroxide, and salicylic acid. 

  • Not all OTC acne medications contain acne-fighting ingredients. Always check labels to make sure your OTC acne treatment contains an active ingredient that treats acne. 

A teen applying pimple cream.
energyy/iStock via Getty Images Plus

Acne is one of the most common — and most annoying — skin issues. Everyone can get the occasional zit. But for some, it may seem like pimples are here to stay, no matter your age. 

Here’s the good news: There are steps you can take to reduce the frequency and severity of breakouts. Some of the best acne treatments are available over the counter, meaning you don’t need a prescription. Here’s our guide to over-the-counter acne medications.

What is acne?

Acne is an inflammatory disorder involving the hair follicles and oil glands. It affects:

  • About 85% of people between ages 12 and 24

  • Roughly 35% of women in their 30s

  • Around 20% of men in their 30s

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Acne can also continue into the 40s and beyond. Even babies can get acne, typically between ages 2 to 12 months. 

Acne usually affects the face and upper torso. You may get open and closed comedones (whiteheads and blackheads), as well as papules, pustules, cysts, and nodules. Some people have no symptoms. But, for others, acne can also be painful or itchy.

Acne is a clinical diagnosis, which means your doctor can typically make it just by looking at you — no fancy diagnostic tests required. But even if you think your pimples are run of the mill, it’s never a bad idea to get checked out by a board-certified dermatologist to make sure. A long list of conditions can mimic acne, including:

Each should be treated differently.

This guide is for people with mild acne who want to try to treat themselves before seeking a doctor’s help. If you’re not responding to OTC acne treatment, you may need prescription-strength therapy — and the sooner the better to help minimize scarring.

What are the different types of OTC acne medications?

There are many different types of OTC treatments for acne. They can include:

  • Washes

  • Lotions

  • Creams

  • Scrubs

  • Peels

  • Vitamins

  • Masks

With new OTC acne treatments hitting the shelves on a regular basis, it can be hard to keep track! The key to choosing among them lies in selecting the right active ingredients for your skin.

Which active ingredients should you look for in OTC acne medication?

Certain OTC acne treatments are backed by more scientific evidence than others. Check the label for the active ingredients in the list below. These have the most studies to support their use.

Retinoids

These vitamin A derivatives are the mainstays of acne treatment. Retinoids reduce the formation of blackheads and whiteheads as well as microcomedones (the microscopic pore clogs that are the precursor to all acne bumps). They’re also anti-inflammatory.

The American Academy of Dermatology recommends using them alone for acne primarily made up of whiteheads and blackheads. But people who tend to get inflamed, deeper-seated acne bumps often need antibiotics or other medication to control their acne.

There are several retinoids approved to treat acne. But adapalene is the only one available OTC. Adapalene comes as a gel and is available in generic and brand forms (Differin). The OTC form comes in only one strength. 

The main side effects of topical retinoids are irritation and drying, so it’s important to use a moisturizer along with retinoids. They also make your skin more sensitive to the sun, so make sure to use a moisturizer with sunscreen (SPF) during the day. 

You should not use topical retinoids if you're pregnant, so be sure to read labels carefully. 

Benzoyl peroxide

Benzoyl peroxide has been used to treat acne for decades. It’s antibacterial and also busts whiteheads and blackheads. It’s available in washes, foams, creams, and gels in concentrations ranging from 2.5% to 10%. 

It’s a good idea to use the lowest-strength product that still works for you. Products containing benzoyl peroxide can be irritating and drying. Using a lower dose can help you avoid these side effects. It can also help to use washes instead of creams or gels that stay on your face. 

Benzoyl peroxide is safe to use if you’re pregnant.

Alpha-hydroxy acids

Glycolic acid and lactic acid are two types of alpha-hydroxy acids (AHAs) available as OTC acne treatments. Glycolic acid is derived from sugar cane, and lactic acid comes from sour milk. Both function as chemical exfoliants, reducing clumping of skin cells and potentially helping heal and prevent acne bumps. 

AHAs are available as washes, creams, lotions, serums, and peels. Both lactic and glycolic acid products come in a range of strengths. Higher-strength products are more acidic. That means it’s more likely to cause side effects, like redness, dryness, and peeling.

Unlike retinoids and benzoyl peroxide, it's not clear whether AHAs work well for everyone. 

Salicylic acid

Salicylic acid is a beta-hydroxy acid (BHA) that also exfoliates the skin and busts whiteheads and blackheads. Like AHAs, it comes in a variety of forms and strengths. Like other OTC acne medications, BHA can cause skin dryness, redness, and peeling. 

A 12-week, randomized, double-blind study found that salicylic acid pads used twice daily were more effective than placebo at reducing inflammatory acne lesions and whiteheads. That said, there’s limited research to support the efficacy of salicylic acid in acne treatment.

Azelaic acid

The American Academy of Dermatology recommends azelaic acid as a supplementary acne treatment. It can also help reduce the pesky brown marks that pimples can leave behind. Like other effective acne treatments, it works by reducing whiteheads, blackheads, inflammation, and skin bacteria. 

It comes in gel, serum, foam, and cream forms. It’s a weaker acid than AHA and BHA, so it may be the right choice for you if other OTC acne treatments cause unwanted side effects.

It’s safe to use if you’re pregnant.

Tea tree oil

Tea tree oil has been used in medicine for more than 70 years. A randomized trial found this antibacterial oil to be almost four times more effective than placebo in reducing total acne lesion count and about six times more effective at reducing acne severity index. 

But tread carefully: Up to 3.5% of people may have a contact allergy to tea tree oil. This means that applying it to your skin can cause a reaction similar to poison ivy. If you choose to try tea tree oil, consider applying a small amount to the inside of your wrist for a few days to make sure you don’t get a reaction before slathering it onto your face.

So, what are the most effective OTC acne medications?

Here are three OTC acne treatments with the strongest evidence backing them up.

1. Benzoyl peroxide wash

Examples of benzoyl peroxide washes include PanOxyl Acne Foaming Wash (about $12) and Neutrogena Clear Pore Facial Cleanser (about $7).

You can use these antibacterial washes three to five times a week, usually in combination with a topical retinoid. They can bleach your sheets and towels, so make sure not to use your favorites. On the off days, opt for gentle cleansers, like CeraVe or Cetaphil, to minimize irritation.

2. Adapalene gel

Examples of adapalene gel include generic adapalene and brand-name Differin (about $13).

You can apply a pea-sized amount to your whole face each night. This can also help prevent future breakouts if you use it consistently. It can take several weeks to see results, and, as the skin purges, you may get a breakout around weeks 4 to 6.

3. A good moisturizer with SPF

A good example is CeraVe AM lotion (about $19).

While these won’t fight off acne, they can help reduce irritation and dryness caused by OTC acne medications. They can also help minimize brown spots that can be left over when acne bumps fade. And remember, if you’re using retinoids, you’ll be more sensitive to the sun. Daily SPF will keep your skin safe from sun damage.

Opt for a moisturizer with oil-free and non-comedogenic labels, which means it won’t clog your pores.

Which OTC acne treatments should you avoid?

Steer clear of abrasive mechanical exfoliant scrubs, like sand-based scrubs. These can create small tears in the skin and lead to more irritation. Though some people swear by their facial cleansing brushes, there’s no evidence yet that they work to treat or prevent acne.

What’s the difference between OTC and prescription acne medications?

In general, OTC acne medications may be enough to treat mild cases of acne, especially for people who get mostly whiteheads and blackheads. But often a prescription acne medication is needed to help people who get large or painful pink or red bumps, or pus bumps. Inflammatory acne may be especially likely to lead to scarring, too. It may warrant aggressive treatment to prevent longer-lasting effects that are difficult to reverse.

There are a few shared ingredients between OTC and prescription acne treatments — like benzoyl peroxide and retinoids. But there’s a greater variety of formulations and strengths available by prescription only. If your acne warrants treatment with medications — like spironolactone, antibiotics, or isotretinoin — you’ll need the help of a dermatologist.

The bottom line

There are several OTC acne medications that can effectively treat and prevent acne. These work best for people with mild acne made up of whiteheads and blackheads. The most effective OTC acne treatments are adapalene 0.1% gel and products with benzoyl peroxide. Alpha hydroxy acid, beta hydroxy acid (salicylic acid), azelaic acid, and tea tree oils are also popular OTC acne treatments. But there’s less evidence that these work well to prevent and treat acne.

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Why trust our experts?

Patricia Pinto-Garcia, MD, MPH
Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.
Maria Robinson, MD, MBA
Maria Robinson, MD, MBA, is a board-certified dermatologist and dermatopathologist who has practiced dermatology and dermatopathology for over 10 years across private practice, academic, and telehealth settings. She is a fellow of the American Academy of Dermatology and the American Society of Dermatopathology.

References

American Academy of Dermatology Association. (n.d.). Acne clinical guideline

Decker, A., et al. (2012). Over-the-counter acne treatments: A review. Journal of Clinical Aesthetic Dermatology.

View All References (6)

de Groot, A. C., et al. (2016). Tea tree oil: Contact allergy and chemical composition. Contact Dermatitis.

Russel, J. J. (2000). Topical therapy for acne. American Family Physician

Sharad, J. (2013). Glycolic acid peel therapy – A current review. Clinical, Cosmetic and Investigational Dermatology

Stringer, T., et al. (2018). Clinical evidence for washing and cleansers in acne vulgaris: A systematic review. Journal of Dermatologic Treatment.

The American College of Obstetricians and Gynecologists. (2022). Skin conditions during pregnancy

YaleMedicine. (n.d.). Acne (acne vulgaris)

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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