top of page

Request a Consultation

Over the Counter Acne Medications


Here is the scoop on the top over the counter acne solutions and acne-fighting ingredients you will find in drugs stores across Boston and America.


What are the most effective ingredients found in over the counter (OTC) acne medications and treatments? 


The most widely used ingredients in most over the counter acne treatments consist of the following:


  • Salicylic Acid – Salicylic acid is a keratolytic agent, meaning it’s a peeling agent that helps remove the horny layer of skin. Salicylic acid also helps cells to shed inside the hair follicles, which in turn prevent the pores from clogging and keeps them free of debris. Salicylic acid is also thought to help clear out whiteheads and blackheads. Salicylic acid concentrations approved for use in over the counter treatments for acne fall between 0.5 percent to 2 percent. The negative side of salicylic acid is that it can cause stinging and skin irritations, such as peeling skin.

  • Benzoyl Peroxide – Probably the most popular treatment for acne, benzoyl peroxide works by adding oxygen to the pores, which kills the bacteria responsible for acne (Propionibacterium Acnes). Like salicylic acid, benzoyl peroxide also helps clear the pores of cellular debris. Benzoyl peroxide products generally come in non-prescription concentrations of 2.5 percent, 5 percent and 10 percent. Side effects can include dryness, redness and flaking. There is evidence that 2.5% benzoyl peroxide actually has the same effectiveness as 10%, just decreased side effects.

  • Alpha Hydroxy Acids (AHAs) – Two of the most common AHAs found in acne products are glycolic acid and lactic acid. These acids target acne by reducing inflammation and ridding of dead skin cells. Another benefit of AHAs is that they help with the appearance of acne scars by promoting growth of newer skin.

  • Sulfur – This ingredient, a natural element, is great for ridding of excess oil in the skin. Sulfur has a smelly egg like odor associated with it, but thankfully many products containing that ingredient today do not smell. Sulfur also helps to remove pore-clogging skin cells. Products with sulfur can cause dry skin.

  • Tea Tree Oil — This natural anti-inflammatory is often used as an acne treatment alternative to the harsher ingredients mentioned above. Research has showed that the topical use of tea tree oil significantly reduces the appearance of inflamed and non-inflamed acne lesions.

  • Retinol – A derivative of vitamin A, retinol is used in the treatment of acne because it increases cell turnover and helps shed abnormal cells from the skins surface. Because retinol also promotes the growth of new collagen and elastin, it’s often used in anti-aging creams. Accutane is actually a form of vitamin A as well. Retinol can cause sensitivity to sunlight as well as flaky, dry skin.

  • Rescorcinol – Sometimes found with sulfur in the formulation, rescorcinol is an antiseptic ingredient that helps get rid of the buildup of dead skin cells. It is found in 2% or less concentrations in over-the-counter acne treatments.



Topical Retinoids


There are many prescription medications available for the treatment of acne. Topical medications include topical retinoids (ie. Retin-A Micro, Differin and Tazorac), topical antibiotics (ie. Clindamycin, Erythromycin) and benzoyl peroxide combination medications (ie. Duac, Acanya and Epiduo.) Oral medications for the treatment of acne include oral antibiotics (ie. Doryx, Solodyn and Azithromycin), oral anti-androgen medications (ie. Spironolactone, Yaz) and oral retinoids, such as Accutane.


How do topical retinoids work in the treatment of acne?


Topical retinoids are derived from Vitamin A. They increase skin cell turnover, therefore promoting the removal of the microcomedone from the follicle. Retinoids are therefore capable of treating and preventing both comedonal acne and inflammatory acne. Retinoids also have anti-aging effects and have been shown to improve the appearance of fine lines.


Are retinoids too irritating to use on sensitive skin?


Most patients are able to tolerate the use of a retinoid, if given proper instruction. It is important for the medical professional to take extra care in choosing the appropriate retinoid for a patient with sensitive skin, and for giving them the knowledge to be able to properly use the medication at home. For most patients, the application of only a pea-size amount is sufficient to treat the entire face. Retinoids can be combined with moisturizers, either before or after the application of the retinoid, in order to increase tolerability. Most patients start by using their topical retinoid only three times weekly or every other night. Eventually, the frequency of use may be increased to nightly applications. If you experience redness or peeling after using a topical retinoid, do not use the medication for 2-3 days. During that time, apply a gentle moisturizer and avoid other potentially irritating products.


Are retinoids available over the counter?


Most retinoids are available by prescription only; the milder form of retinoids, retinol, is available in over the counter preparations. Retinol is slowly converted to retinoid once applied to the skin, but in significantly lower concentrations. This means that the ability of retinol to treat acne is much lower and the results will be disappointing when compared to regular use of a prescription retinoid.

bottom of page