Acne afflicts people of all ages. Oily skin, fluctuating hormones, periods of stress, shaving, sun cream – all can play their part, with excess sebum and bacteria, to clog pores and cause blackheads and pimples in men and women from 14 to 64, with some suffering more than others. The NHS estimates that 95% of people aged 11 to 30 can suffer acne, alongside a sizable minority over that age too.
If you’re one of those affected, it can feel like there isn’t much that you can do about it. This isn’t the case, however. Over-the-counter (OTC) acne treatments are extremely effective, but a degree of patience is required to see results. Ingredients such as salicylic acid, benzoyl peroxide and niacinamide all work in slightly different ways to stop your pores from becoming congested. So while they don’t work overnight, they do prevent breakouts in the long-term.
In the buying guide that follows, we take advice from a pharmacist regarding the best over-the-counter (OTC) treatments for acne, depending on skin type. Then, further down you’ll find our recommendations of the best acne treatments available.
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Best acne treatment: At a glance
How to choose the best acne treatment for you
How do OTC acne treatments work?
Most over-the-counter (OTC) acne treatments include ingredients that fight the causes of breakouts, rather than tackling any spots already visible. They achieve this by clearing your pores of excess sebum (oil), dead skin cells and other matter that encourages acne bacteria to multiply and, as a result, trigger breakouts. This can help, even if you suffer from hormonal acne, since disrupted hormones tend to over-produce sebum. Note that it may take a few weeks before you see results, though.
“If you’re suffering from a milder form of acne, which is to say a few spots or blackheads, over-the-counter medicines can really help,” says Hussain Abdeh, superintendent pharmacist at Medicine Direct. The British Association of Dermatologists’ (BAD) guide to acne agrees, recommending topical treatments such as creams and gels as “the first choice for those with mild to moderate acne”.
How should I use a new acne treatment?
“It’s best to speak to a pharmacist before buying acne treatment,” says Hussain Abdeh. “Your skincare regimen can be built around your treatment, too. For instance, if your acne treatment tends to dry out your skin, apply a gentle moisturiser after the acne medicine has absorbed into the skin. This will give your medication enough time to get to work, without compromising the quality of your skin.”
The BAD warns that some topical treatments can be irritating to the skin, so it’s wise to start by applying them to a small area of affected skin a few times to check for any unwelcome reactions. Once you know your skin is okay with a particular treatment, you should apply it to all the areas of your face (and back, and other acne-afflicted areas) that suffer from breakouts, rather than just to the individual spots you can see.
What ingredients should I look for in the best acne treatment?
Salicylic acid is a beta hydroxy acid (BHA) that acts as an exfoliant, absorbing deep into skin to break down the “glue” that holds dead skin cells together. This helps to clear pores and prevent the buildup of dead skin and excess oil. OTC salicylic acid products are available in strengths up to 5%, which is strong enough to help clear up problem skin.
Glycolic acid and lactic acid are the two alpha hydroxy acids (AHAs) that often appear in OTC acne treatments. Better known as anti-aging ingredients, they’re also effective for treating acne because they stimulate cell turnover in the top layers of your skin. “These acids can help treat acne by reducing inflammation and clearing away dead skin cells,” says Hussain Abdeh. “Furthermore, they promote new skin growth. This helps to create fresh, smooth skin to improve its overall appearance, also reducing any acne scarring.”
Azelaic acid isn’t an AHA or a BHA, but a byproduct of yeast that occurs naturally in our skin. Its main role in fighting spots is to act as an exfoliator, but it also has impressive anti-bacterial and anti-inflammatory properties. It’s particularly good for penetrating your skin and tackling the problems that often coincide with acne, such as rosacea and high pigmentation. Note that it can cause irritation in some users, however.
Succinic acid is a relative newcomer, beloved by skincare experts for its ability to clear pores without causing irritation. Succinic acid has antimicrobial and anti-inflammatory properties, too, and won’t dry out skin.
Niacinamide aka nicotinamide is a form of vitamin B3. Applied to the skin in an acne treatment, it does a great job of balancing oil production and calming breakouts. In some people it has a brightening effect, too, helping to even out a patchy skin tone.
“Benzoyl peroxide is a highly renowned ingredient that is effective in treating many cases of acne,” says Abdeh. “It works to remove excess oil from the skin, as well as remove dead skin cells, which can unclog pores. Furthermore, benzoyl peroxide kills the bacteria that cause acne, helping to clear existing spots and prevent future ones from appearing.” Abdeh sounds a note of caution, however. “You may experience stinging, redness, or burning while using products that contain this ingredient; it can also dry out the skin, so using a moisturiser is often beneficial.”
Tea tree oil has anti-inflammatory properties to help calm acne and reduce redness. It’s natural, but no weakling: 5% tea tree oil has results comparable to 5% benzoyl peroxide. Like benzoyl peroxide, prolonged use may not suit sensitive skin.
Retinol is a vitamin A derivative that works in a similar way to AHAs, increasing the turnover rate of skin calls and potentially smoothing out both wrinkles and acne. In the UK, you need a prescription for high-strength retinol medications such as Differin, but you can buy lower-dose retinol treatments over the counter.
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The best acne treatments to buy now
1. The Inkey List Succinic Acid Blemish Treatment 15ml: The best all-round acne treatment
Price: £8 for 15ml | Buy now from Look Fantastic
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Succinic acid is one of the newer acne-fighting ingredients, able to reduce inflammation and the chance of future breakouts by lifting impurities from pores. The rich, creamy texture may alarm acne sufferers who may want to “dry out” their zits to clear them, but this treatment really works to soothe inflamed skin. It also works wonders for balancing your skin’s natural oil production; drying products can upset the balance of oils in the long-term. The cream absorbs quickly and doesn’t leave any residue, so it’s great for use under makeup.
Key specs – Size: 15ml; Format: Cream; Active ingredient: Succinic acid 2%, salicylic acid 1%
2. Paula’s Choice Clear Skin Clearing Treatment: The best acne treatment with pore-erasing effect
Price: £37 for 30ml | Buy now from Paula’s Choice
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This treatment from skincare superstar Paula Begoun manages to blur and clear pores at the same time. The light, hydrating gel-like formula has the instant softening effects of a pore-minimising serum; but, behind the scenes, its combination of azelaic and salicylic acid exfoliates both the top and deeper layers of your skin, clearing out the gunk that causes spots.
We tried it on congested areas with blackheads, whiteheads and a few small zits, and although it didn’t work overnight, it yielded results within days, making skin feel and look smoother. It appeared to loosen blackheads, too, making them much easier to extract. Be aware that azelaic acid can cause irritation on the first few times it’s applied. And while we really rate this product, it’s on the pricey side.
Key specs – Size: 30ml; Format: Gel lotion; Active ingredient: Azelaic acid, salicylic acid
3. The Ordinary AHA 30% + BHA 2% Peeling Solution: The best skin peel treatment
Price: £6.30 for 30ml | Buy now from Look Fantastic
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Save a fortune on a salon skin peel by forking out a mere £6.50 for this peel (actually, multiple peels) in a bottle. The combination of AHAs and BHAs exfoliate the top and lower layers of your skin respectively, while hyaluronic acid soothes and softens. This low-viscosity solution is super-easy to apply with a cotton wool pad, and it requires only 10 minutes to dramatically smooth your skin.
The “very high concentration of free acids” does sound scary, but it works to battle breakouts. Most people shouldn’t suffer any ill-effects, but as with all acne treatments, it’s worth testing the product on a small area of your skin before you get carried away. In addition, be absolutely sure to wear sunscreen for a week after your peel, because AHAs make your skin much more susceptible to sunburn.
Key specs – Size: 30ml; Format: Liquid; Active ingredient: Salicylic acid, lactic acid, tartaric acid, hyaluronic acid
4. Acnecide Face Gel 5%: The best benzoyl peroxide acne treatment for oily skin
Price: £8 for 15g | Buy now from Amazon
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When the going gets tough, the tough get benzoyl peroxide. You can buy acne treatments containing up to 10% of this powerful antibacterial ingredient, which is extremely effective at unclogging pores and drying out zits. However, our own long-suffering experience suggests that 5% is a much more effective strength, because you can use it longer-term without it irritating your skin.
Acnecide is the best and most widely available benzoyl peroxide-containing acne treatment you can buy, and it offers excellent value. This light gel contains glycerine to counteract the drying effects of its main active ingredient, but be careful to avoid super-sensitive areas such as your neck, because it will cause redness following a few days of daily use. More importantly, though: it works.
Key specs – Size: 15g; Format: Gel; Active ingredient: Benzoyl peroxide 5%
5. REN Clean Skincare Clearcalm Non-Drying Spot Treatment: The best acne treatment for dry, sensitive skin
Price: £20 for 15ml | Buy now from Look Fantastic
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Acne tends to be associated with youthful oily skin, but people with dry, over-sensitive complexions can often suffer from spots as well – and then find that many acne treatments are too harsh for their skin type. No such problems with this calming lotion, which is formulated with all manner of natural bio-active ingredients including xylitol and chlorella extract to soothe irritation, aid recovery and rebalance healthy bacteria. However, the main active ingredient is salicylic acid, which gets to work clearing pores and preventing breakouts.
Despite its calming properties, don’t be tempted to slather this stuff on too thickly: its salicylic acid content is effective in small doses, and this 15ml tube is designed to last weeks.
Key specs – Size: 15ml; Format: Lotion; Active ingredient: Salicylic acid
6. Zitsticka Killa Kit: The best acne treatment patch for emergency zits
Price: £27 for 8 patches | Buy now from Cult Beauty
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Eight fingertip-sized spot-killing patches for little under £30 is quite a lot of money, but these little beauties do a brilliant job of reducing those horrible angry, deep and cystic spots that appear the day before a big night out. Stick a patch onto a spot, and its 24 “microdarts” fire salicylic acid, hyaluronic acid and niacinamide directly into the skin, reducing inflammation and clearing infection. You can sleep, shower and even go for a swim with a patch in place – it won’t budge.
The microdarts do literally penetrate your skin, so you’ll feel a bit of a tingle on application; but it isn’t painful. In fact, one of these patches can quickly reduce the pain of cystic spots that are the dreaded hallmark of hormonal acne.
Key specs – Size: 8 patches plus 8 priming swabs; Format: Patch; Active ingredients: Salicylic acid, hyaluronic acid, niacinamide