The best ingredients for fighting acne, according to dermatologists

Ashley LadererSep 25, 2020, 02:31 IST

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Acne can be treated with products that have anti-inflammatory and anti-bacterial properties.Boy_Anupong/Getty Images

The best ingredients for acne are benzoyl peroxide, salicylic acid, alpha-hydroxy acids, retinol, tea tree oil, and sulfur.
Ingredients like benzoyl peroxide, alpha-hydroxy acids, tea tree oil, and sulfur have antibacterial properties, which help kill acne-causing bacteria.
Salicylic acid removes the top layer of dead skin cells, which helps unclog pores and reduce breakouts.
This article was medically reviewed by Debra Jaliman, MD, a board-certified dermatologist with a private practice in New York City.

Acne is extremely common in the United States, affecting around 50 million Americans every year. Acne can be stubborn and hard to get rid of, but there are many treatments available, both over the counter and via prescription, that can help you get clear skin.

With a huge assortment of anti-acne products out there to choose from, how do you know which is best for you? Many acne treatments differ mainly by their active ingredients. We're breaking down 6 ingredients, from how they work to how to use them. Here's what you need to know.

Benzoyl peroxide

How it's beneficial for acne: Benzoyl peroxide is an over the counter topical medication that reduces the amount of acne-causing bacteria that lives on the skin, says Teo Soleymani, MD, FAAD, a board-certified faculty dermatologist and Mohs Micrographic surgeon at UCLA.

By killing acne-causing bacteria, it can reduce the number of whiteheads and larger pimples, as well as reduce the frequency of breakouts, says Soleymani.

A large 2020 meta-analysis published in Cochrane Library looked at almost 30,000 participants and found that benzoyl peroxide is more effective than a placebo in treating acne.

How to use this product: You can find benzoyl peroxide in cleansers that should be used once or twice daily.

What concentration you should use: Less is more in the case of benzoyl peroxide. Soleymani says using benzoyl peroxide with a concentration of 2-5% should work just as well for facial acne at higher concentrations of 10% or more. Lower concentrations will not be as harsh or drying to the delicate skin on your face.

With that in mind, acne on the chest and back may require higher concentrations of benzoyl peroxide to see results, says Cliff Perlis, MD, board-certified dermatologist at Keystone Dermatology Partners outside of Philadelphia, Pennsylvania. While a higher strength like 10% may be too much for the face, it can do the trick for pesky acne on the back or other parts of the body.

How long it takes to work: It takes about two weeks or more to start seeing improvement, says Perlis.

Salicylic acid

How it's beneficial for acne: Salicylic acid is a beta-hydroxy acid (BHA) that removes the top layer of dead skin cells, says Soleymani. It is able to do this by deeply penetrating the pores, thereby unclogging them.

By unclogging your pores, Soleymani says that salicylic acid can reduce the number and size of blackheads. It can also help rid your skin of excess oil, thereby preventing new pimples.

A 2015 comprehensive review published in Clinical, Cosmetic and Investigational Dermatology determined that salicylic acid is safe and effective in treating acne.

How to use this product: You can use this product in a cleanser, gel, moisturizer, or cream. Perlis says it should be used once or twice a day, depending on the particular product you are using. Read the label for suggested use.

What concentration you should use: As with the benzoyl peroxide, a higher concentration of salicylic acid does not mean it will be more effective. You'll likely see concentrations available ranging from .5% to 5%. Soleymani says 1% to 2% is a good target to use.

How long it takes to work: You'll see results in one to two weeks, Soleymani says.

Alpha-hydroxy acids (AHAs)

How it's beneficial for acne: AHAs are a group of chemical exfoliants. They remove dead skin cells, prevent the collection of sebum (oil) and prevent bacterial overgrowth, Perlis says. There are different types of AHAs such as:

Lactic acid
Mandelic acid
Glycolic acid

By removing dead skin cells and getting rid of excess oil, AHAs can help to unclog pores thereby reducing breakouts.

Studies have shown AHAs to be moderately beneficial. A 2010 study published in the Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases examined 248 participants with mild to moderate acne over the course of 60 days and found that the effectiveness was high in 64.2% of patients, decreasing the prevalence of mild to moderate acne in participants, and that it was very tolerable on the skin.

How to use this product: Soleymani says AHAs are best used at low concentrations in a once-daily cleanser. Alternatively, you can use it as a chemical peel exfoliant once a week or so at higher concentrations, like 10-15%, but Soleymani recommends checking with a dermatologist first since it may irritate skin.

At first, when you use AHAs, you might experience tingling, itchiness, and dryness, Perlis says. If this happens, decrease your usage to every other day or every third day until you get used to the product. Once you're used to it, you can increase the frequency. Perlis also stresses the importance of using sunscreen if you are using AHAs in your skincare routine since AHAs make your skin more sensitive to UV radiation.

What concentration you should use: In a cleanser, Soleymani says you should look for 3% to 8%. Concentrations higher in peels and masks should be used with caution since they can cause serious damage if used incorrectly.

How long it takes to work: AHAs work pretty quickly, and you can see improvement in a week or less, Soleymani says.

Retinol

How it's beneficial for acne: Retinol is a type of retinoid, which is a vitamin A derivative, Soleymani says. It can increase the skin-cell turnover rate by getting rid of the top layer of dead skin cells, and promoting the growth of new collagen and healthy new skin cells.

Soleymani says retinol is great for reducing the size and frequency of blackheads, whiteheads, and even deeper painful pimples, due to its skin-cell turnover abilities. Plus, it will improve the overall texture and tone of your skin.

A 2017 review published in Dermatology and Therapy stated that retinoids should be a mainstay treatment for acne since it has been shown to be effective in treating different types of acne in "many thousands" of patients.

How to use this product: Retinol is typically available in gel form. Perlis says the rule of thumb is to "start low and go slow," meaning start with low concentrations and not applying every day, since retinoids can cause redness, itching, dryness, and sun sensitivity.

Perlis suggests applying every other night or every third night when you first start out to reduce irritation, then you can eventually increase the frequency to every day.

It should always be applied to dry skin. Applying to wet skin can increase irritation. Perlis says. Additionally, Soleymani says it is best to apply retinol at night before bed, and to use a moisturizer after to combat the dryness that may occur. Additionally, they should not be used during pregnancy.

What concentration you should use: It is not common to see the concentration of retinol in OTC products since it is an inactive version of retinoic acid, says Soleymani. However, Differin, the most common OTC retinol has a concentration of .1%.

But if you get a prescription-strength retinoid from a dermatologist, the concentration will range from 0.025% to 1%, and the right strength for you will be determined by your dermatologist.

How long it takes to work: It takes a longer time for retinoids to work. Regardless of if you are using an OTC retinol like Differin or a prescription-strength retinoid, it will likely take 4 to 6 weeks or more to see results, Perlis says.

Tea tree oil

How it's beneficial for acne: Perlis says that tea tree oil has anti-inflammatory and antibacterial properties, which may be helpful for acne. "I stress the word "may," because the studies supporting it are small and much lower quality than the research for some other [acne] treatments discussed," says Perlis.

One 2017 study published in the Australasian Journal of Dermatology examined 18 people with mild to moderate acne, and found that a tea tree oil gel was effective in reducing acne. However, more larger-scale studies are necessary to really determine the efficacy.

How to use this product: Soleymani says to use tea tree oil in a cleanser. Tea tree oil as an essential oil should not be applied straight to the skin because it can cause a rash.

What concentration you should use: Perlis says the lack of standardization across tea tree oil products makes it difficult to provide guidelines for concentrations or application.

How long it takes to work: Based on the Australasian Journal of Dermatology study saw slight results after 4 weeks, and even more after 12 weeks.

Sulfur

How it's beneficial for acne: Soleymani says it reduces the frequency of both blackheads and whiteheads. This happens because it removes the top layer of skin cells, which unclogs pores. Additionally, Perlis says it can decrease the redness and size of pimples.

A 2009 review published in Clinical, Cosmetic and Investigational Dermatology stated that sulfur was effective as a drying and antibacterial agent for acne and that it was suitable for sensitive skin.

How to use this product: Sulfur is available in cleansers and maks or spot treatments that are meant to just be applied to problem spots.

What concentration you should use: Soleymani says you should opt for a product with a sulfur concentration of 3% to 5% should be used.

How long it takes to work: Spot treatments can improve the appearance of pimples in just a few days, Perlis says. Using a less concentrated cleanser can take a couple of weeks to show results.

When to see a doctor

If your acne isn't improving at all after about a month of trying products with these ingredients, you should go see a dermatologist. They can help you come up with a more effective skincare routine, or they may determine that you need something stronger such as a prescription topical treatment or an oral treatment such as antibiotics.

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