Over-the-counter acne products: What works and why

Many acne products are available in pharmacies and drugstores. Find out how they differ, what main ingredients to look for and how to use these products for best results.

By Mayo Clinic staff (mayoclinic.com)

Many over-the-counter (OTC) acne products are available to treat mild to moderate acne or periodic breakouts. But with so many acne products lining store shelves, how do you know which one is best for you?

Before you grab whatever package is closest, learn how OTC acne products work and what ingredients to look for. Then, develop a gentle skin care regimen to treat and prevent acne breakouts.

Acne products target causes

Your hair follicles are connected to sebaceous glands, which secrete an oily substance known as sebum to lubricate your hair and skin. Sebum normally travels up the hair shafts and then out through the opening of the hair follicle onto the surface of your skin.

When your body produces an excess amount of sebum and dead skin cells, they can accumulate in the hair follicle and form a soft plug. As the plug enlarges, the follicle wall can rupture, allowing more oil and skin cells to accumulate. Bacteria can trigger inflammation and infection resulting in acne.

Some OTC acne products work by killing Propionibacterium acnes (P. acnes), the bacteria that cause acne inflammation. Other acne products remove excess oils from the skin or speed up the growth of new skin cells and the removal of dead skin cells. And in some cases, acne products work by doing a combination of these things.

Active ingredients in acne products

Acne products work in different ways, depending on their active ingredient. Here are common active ingredients found in acne products and how they work to treat acne.

* Benzoyl peroxide – Probably the most effective active ingredient in acne products, benzoyl peroxide kills P. acnes, helps remove excess oils from the skin and removes dead skin cells that clog pores. Available in strengths from 2.5 percent to 10 percent, benzoyl peroxide can cause excessive dryness, scaling, redness and minor swelling. It can also make your skin more sensitive to ultraviolet (UV) exposure.

* Salicylic acid – This ingredient slows shedding of cells inside the hair follicles, which prevents the pores from clogging. It may also break down whiteheads (clogged pores that have no opening) and blackheads (pores that are open and have a dark surface). Salicylic acid can cause mild stinging and skin irritation. OTC acne products are available with 0.5 percent to 2 percent salicylic acid.

* Sulfur and resorcinol – Rarely used alone, sulfur and resorcinol are often found together in acne products. These ingredients remove dead skin cells that clog pores and help remove excess oil. They may also break down whiteheads and blackheads. Sulfur and resorcinol can cause redness and peeling, which may occur several days after using the product.

* Alcohol and acetone – Often available in astringents and other cleansing washes, alcohol and acetone remove dirt and oils from the skin. Acne products that contain these ingredients can cause a mild burning or stinging sensation.

Using acne products for best results

To minimize redness, excessive dryness and other skin problems, start out with lower strength acne products. If needed, gradually increase the strength and frequency of your applications so that your skin can adjust to the treatments.

Acne products are just one step in your skin care regimen. For best control of acne:

* Avoid oily cosmetics, sunscreens and hair products. Instead use products labeled “oil-free” or “noncomedogenic,” which means they won’t clog pores.

* Wash problem areas twice daily with a nonmedicated soap or mild cleanser. But don’t overdo it. Excessive washing and scrubbing can worsen acne.

* Apply just enough acne product to cover the problem areas.

* Use an oil-free, water-based moisturizer to help alleviate dry, peeling skin.

* Don’t pick or squeeze blemishes. Infection or scarring may result.

Treating acne with acne products takes time and patience. It may take four to six weeks of daily use of acne products to see results, and acne may look worse before it gets better. If your acne doesn’t improve after two months of treatment, you may want to see your doctor or dermatologist for a prescription lotion or medication.

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