Over the Counter Acne Treatment
Over the counter acne treatment products are the first line of defense against acne. The active ingredients in OTC acne medications are usually one of these three: sulfur, salicylic acid, or benzoyl peroxide. They are used for mild-to-moderate acne cases and are the active components in many well-known acne treatment systems like Proactiv and Neutrogena.
OTC acne products typically include spot treatments, cleansers, toners, astringents, moisturizers, lotions, pads and wipes, masks and strips. Some contain other active ingredients like retinol, resorcinol, and alphahydroxyl acids (AHA). However, these three are by far the most commonly used.
A question that's being asked repeatedly is "what's the best over the counter acne treatment product?" The answer, as discussed here, is that it depends on what works for you, because every person's case is different.
Salicylic Acid
- Salicylic acid works by peeling the skin and thus prevents formation of blackheads and whiteheads
- Available in 0.5% - 2.0% concentration as wash solution, cream, lotion, etc.
- Non-prescription and usually more affordable
- Compared with tretinoin, it is not as effective or irritating
- Many formulations combine it with benzoyl peroxide as salicylic acid tends to work on the upper layer of the skin while benzoyl peroxide tends to work deeper into the dermis. However, this combination may be too harsh for some people
- Common products containing salicylic acid include: Oxy®, Noxzema®, Stridex®, and Dermalogica®
Sulfur
- Preparations containing sulfur has been traditionally used to treat pimples and other skin diseases or more than a thousand years
- Sulfur works by killing bacteria and by peeling the skin (keratolytic agent) to prevent clogging of the pores
- Sometimes sulfur is combined with resorcinol, another keratolytic agent
- Sulfur can cause staining and has an unpleasant smell
- Sometimes sulfur is combined with the antibiotic Sulfacetamide for stronger action against bacteria
- Brand names include Nicosyn®, Novacet®, and Sulfacet-R®
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Benzoyl peroxide
- Benzoyl peroxide is another popular over-the-counter product used for mild to moderate acne.
- Works in 2 ways:
- As an oxidizer, it kills the p. acnes bacteria without causing bacterial resistance unlike antibiotics;
- As a keratolytic agent, it causes peeling of the skin, thus clearing the pore and prevents formation of whiteheads and blackheads
- Available as a lotion, cream, gel, liquid, bar, mask, and cleanser in varying concentrations, from 2.5% up to maximum of 10%
- Non-prescription; used once or twice a day
- In one study, about 70% of participants using a 10% benzoyl preparation experienced clearing of acne within 6 weeks
- May irritate the skin and case dryness and redness. Therefore, it may need to be combined with non-comedogenic (does not block the pores) moisturizers to avoid drying the skin too much.
- May cause bleaching of hair or fabrics due to its oxidizing property
- Not used with tretinoin because it deactivates the latter
- Active ingredient in brands such as BenOxyl®, PanOxyl®, Solugel®, BenzacW®, Clearasil®, Dermoxyl®, etc.
- One of the main ingredients in the popular product Proactiv®
- It is combined with the antibiotic erythromycin in the prescription medication Benzamycin® to treat moderate-to-severe acne.
- Also used in combination with the antibiotic Clindamycin (BenzaClin®, Clindoxyl®) to treat inflammatory acne
Next: Acne Treatment with Prescription Topicals
