Thrifty DIY home decor and easy crafts

20 picks · checked against the 2024 AAD guideline

Best acne treatments

The best acne treatments are adapalene or salicylic acid for clogged pores and benzoyl peroxide for red pimples, plus treating the cause that keeps making new ones: hormones, diet, stress or the gut.

Written by the bestacnetreatments.io editors

The 20 best acne treatments, ranked

Acne is pores plugged with oil and dead skin that swell when bacteria multiply.

The spot you see most picks the skin treatment; your top cause keeps making new ones. Our guide to acne vulgaris treatment covers each type. Some bumps only look like acne: itchy, same-size spots may be fungal acne (#15); flushing without blackheads is more like rosacea.

Start here: treat the spots you see Ayurveda calls this Pitta-rakta, ‘heat in the blood’

Signs: blackheads, whiteheads, red sore pimples.

1. 1 Benzoyl peroxide

   Over the counter AAD: strong

   Benzoyl peroxide kills the acne bacteria (Cutibacterium acnes) inside the pore and calms red, sore pimples. Unlike with antibiotics, bacteria have not been shown to grow resistant to it, so it keeps working month after month. You don’t need a high strength: a 2.5% gel worked about as well as 10% with less peeling. A wash is the easiest way to start; leave it on your skin for 2 to 3 minutes before you rinse, and use white towels, because it bleaches fabric.

   • Best for: Red, sore pimples
   • How to use: 2.5 to 5% gel, or a wash left on 2 to 3 minutes
   • Results in: 2 to 3 months
   • Side effects: Dryness; bleaches towels
   • Pregnancy: OK in limited amounts; ask your doctor (AAD)
   More detail

   Pairs with: #2 Adapalene

2. 2 Adapalene 0.1%

   Over the counter AAD: strong

   Adapalene is a retinoid: it makes the lining of the pore shed normally, so oil and dead skin stop forming the plugs (blackheads and whiteheads) that every pimple starts from. That makes it a treatment you stay on, not a spot fix. Use a pea-sized amount on the whole face at night, every other night for the first two weeks. Skin may look worse in the first weeks before it gets better; most people see the change at 8 to 12 weeks.

   • Best for: Blackheads, whiteheads, small bumps
   • How to use: Pea-sized, whole face, at night
   • Results in: 8 to 12 weeks
   • First weeks: May look worse at first; keep going (Differin label)
   • Side effects: Dryness, peeling, sun sensitivity
   • Pregnancy: Avoid (AAD)
   More detail

   In 2016 it became the first retinoid sold without a prescription. A moisturizer and daily sunscreen keep the first weeks easier.

   Pairs with: #1 Benzoyl peroxide

3. 3 Salicylic acid

   Over the counter AAD: conditional

   Salicylic acid is a beta hydroxy acid (BHA) that dissolves in oil, so it gets inside the pore and loosens plugs from within. It suits oily skin, blackheads and acne on the back and chest, where a wash is easy to use in the shower. It does little for red, swollen pimples, so pair it with benzoyl peroxide if you have those. Use it on different nights from a retinoid to keep dryness down.

   • Best for: Oily skin, blackheads, back and chest
   • How to use: 0.5 to 2% wash or leave-on, 1 to 2 times a day
   • Results in: 2 to 3 months
   • Side effects: Dryness, stinging
   • Pregnancy: Fine briefly as a wash; ask your doctor (AAD)
   More detail

   Leave-on products at 0.5 to 2% work too. Start once a day and add a second use only if your skin stays comfortable.

   Pairs with: #2 Adapalene

4. 4 Azelaic acid

   Over the counter AAD: conditional

   Azelaic acid keeps pores open, calms redness and fades the dark marks pimples leave behind, which makes it a good fit for darker skin that marks easily. It is also one of the usual picks in pregnancy. The 10% you can buy without a prescription is milder; a doctor can prescribe 15 to 20%. Expect a light tingle for the first week or two. More on acne redness treatment.

   • Best for: Red spots with dark marks, darker skin, pregnancy
   • How to use: 15 to 20% Rx, twice a day; 10% is milder
   • Results in: 2 to 3 months
   • Side effects: Tingling at first
   • Pregnancy: Thought to be safe (AAD)
   More detail

   Pairs with: #1 Benzoyl peroxide

Cause: hormones

Signs: deep, tender spots on the chin, jaw or neck; flares with hormone shifts like puberty, a monthly cycle, testosterone or steroids; acne that lasts past 25. Irregular periods or extra facial hair? Ask about PCOS. More on hormonal acne.

1. 5 Clascoterone 1% cream

   Prescription AAD: conditional

   Clascoterone was the first cream to block androgens (the hormones that drive oil) right at the oil gland, FDA-approved in 2020 for anyone from age 12. Because it works in the skin instead of through the whole body, it is the hormone option for men and teens, and for women who can’t take a hormone pill. Use a thin layer twice a day and give it about 12 weeks.

   • Best for: Hormonal acne from age 12, even if you can't take a hormone pill
   • How to use: Thin layer, twice a day
   • Results in: About 12 weeks
   • Side effects: Redness, itching, dryness or flaking
   • Avoid if: Pregnancy: ask your doctor
   More detail

   Keep to the prescribed amount: overuse on large areas can affect the adrenal glands and potassium (FDA label).

   Pairs with: #1 Benzoyl peroxide

2. 6 Spironolactone

   Prescription AAD: conditional

   Spironolactone is a blood pressure pill that also blocks androgens at the oil glands. Dermatologists prescribe it for women whose acne sits low on the face and flares before their period, often after creams alone haven’t worked. The dose is raised slowly, and results show after about 3 months. It must never be taken in pregnancy, so it is often combined with the birth control pill.

   • Best for: Adult women with jawline flares before their period
   • How to use: Daily pill; dose raised slowly
   • Results in: About 3 months
   • Side effects: Irregular periods, sore breasts, dizziness
   • Avoid if: Pregnancy, potassium supplements
   More detail

   Prescribed off-label for acne low on the face. It is never used in pregnancy, so it is often paired with the pill; skip potassium supplements while on it (AAD).

   Pairs with: #7 The pill

3. 7 Combined birth control pill

   Prescription AAD: conditional

   The combined pill (estrogen plus progestin) lowers the androgens that drive oil, and four brands are FDA-approved to treat acne. It suits women whose breakouts follow their monthly cycle and who also want birth control. The change shows slowly, so judge it after the third pack. Smoking at 35 or older, migraine with aura or a past blood clot rule it out.

   • Best for: Breakouts that follow a monthly cycle
   • How to use: One pill a day
   • Results in: 2 to 3 months
   • Side effects: Nausea, spotting; small clot risk
   • Avoid if: Smoking at 35+, migraine with aura, past clots
   More detail

   Pairs with: #6 Spironolactone

Cause: lifestyle (diet and deficiencies) Ayurveda calls this Kapha, ‘heaviness’

Signs: worse after sweet weeks, skim milk or whey; little sun, fish or nuts.

1. 8 Low-glycemic eating

   Lifestyle 1 trial

   Foods that spike blood sugar fast, like white bread, soda and sweets, raise insulin and a growth hormone called IGF-1, and both push the oil glands to make more oil. In a 12-week trial, young men on a low-glycemic diet had fewer spots. You don’t need a strict diet: swap the biggest sugar hits for whole grains, beans and protein. Pairing starch with protein or vegetables also softens the sugar spike of that meal.

   • Best for: Acne worse after sweet or starchy weeks
   • How to use: Swap white bread, soda and sweets for whole grains and protein
   • Results in: About 12 weeks
   More detail

   Pairs with: #9 A2 milk

2. 9 Switching to A2 milk

   Lifestyle Studies link

   The link with acne is strongest for skim milk and whey shakes, which raise insulin and a growth hormone called IGF-1; whole milk shows a weaker one. So the fix is a switch, not cutting milk out: swap whey shakes for a plant protein and skim milk for whole A2 milk. A2 milk skips the A1 protein that upsets digestion for some people, though it hasn’t been tested for acne yet. Give the switch 4 weeks and watch whether fewer new spots appear.

   • Best for: Acne worse with skim milk or whey shakes
   • How to use: Swap whey shakes for a plant protein and skim milk for whole A2 milk; judge it after 4 weeks
   • Results in: 4 to 12 weeks
   More detail

   Skim milk had the strongest link with teenage acne in 47,000 women. A2 milk has been tested for digestion, not yet for acne.

   Pairs with: #14 Fiber

3. 10 Omega-3 fats

   Lifestyle 1 trial

   Omega-3 fats calm inflammation, which may help red, swollen pimples. In a 10-week trial, about 2 g a day (EPA plus DHA) reduced inflamed spots. Take it from fish or algae oil, and not together with milk. Ask your doctor first if you take blood thinners.

   • Best for: Inflamed spots
   • How to use: 2 g of omega-3 (EPA plus DHA) a day, from fish or algae oil, not with milk
   • Results in: About 10 weeks
   • Side effects: Fishy burps
   • Avoid if: Blood thinners: ask first
   More detail

   Pairs with: #8 Low-glycemic

4. 11 Zinc

   Over the counter Trials

   Zinc helps calm skin inflammation, and people with acne tend to have lower levels. In a 3-month trial, 30 mg of zinc gluconate a day helped inflamed acne, though less than an antibiotic did. Take it with food to avoid nausea, and don’t stay above 40 mg a day for months, because too much zinc lowers your copper.

   • Best for: Inflamed acne
   • How to use: 30 mg zinc gluconate a day, with food
   • Results in: About 12 weeks
   • Side effects: Nausea
   • Avoid if: Over 40 mg a day (34 for teens) for months
   More detail

   Pairs with: #1 Benzoyl peroxide

5. 12 Vitamin D

   Over the counter 1 trial

   Vitamin D helps keep skin inflammation in check, and people with acne are more often low in it, especially in winter or with little sun. In a small trial, people who were low and took 1,000 IU a day for 2 months had fewer red pimples. It mainly helps if you are actually low, so a blood test tells you whether it’s worth it. Take it with a meal that has some fat.

   • Best for: Red pimples if you're low in vitamin D
   • How to use: 1,000 IU a day with food
   • Results in: About 8 weeks
   • Side effects: None at this dose
   • Avoid if: Over 4,000 IU a day for months
   More detail

   Pairs with: #11 Zinc

Cause: stress and sleep Ayurveda calls this Vata, ‘irregularity’

Signs: worse in exam or deadline weeks.

1. 13 Steady sleep and stress relief

   Lifestyle 1 study

   Stress raises cortisol and adrenal androgens, which push the oil glands; in one study, students broke out more during exam weeks. Short sleep feeds the same stress response. One fixed bedtime with 7 to 9 hours, and screens off 30 minutes before, is the simplest fix. It won’t clear acne on its own, but it can take the edge off flares in busy weeks.

   • Best for: Acne worse in exam or deadline weeks
   • How to use: One bedtime, 7 to 9 hours, screens off 30 minutes before
   • Results in: Judge it after a month
   More detail

   Pairs with: #8 Low-glycemic

Cause: the gut Ayurveda calls this weak agni, ‘digestive fire’

Signs: acne with bloating or irregular digestion, or that came back after antibiotics.

1. 14 Fiber and fermented food

   Lifestyle Small trials

   Gut bacteria help shape inflammation and blood sugar, and they live on fiber. Small studies found different gut bacteria in people with acne, but whether fixing the gut clears skin is still early science. Eating 25 to 30 g of fiber a day from beans, oats, vegetables and fruit is low-risk and good for you anyway; add a glass of spiced buttermilk (takra) with lunch, the fermented drink Ayurveda recommends for digestion. Expect some gas in the first week or two.

   • Best for: Acne with bloating, or back after antibiotics
   • How to use: 25 to 30 g of fiber a day, including a prebiotic such as GOS, and a glass of spiced buttermilk (takra) with lunch
   • Results in: About 12 weeks
   • Side effects: Gas at first
   • Avoid if: Weak immune system: ask first
   More detail

   Ask your doctor about a Lactobacillus probiotic: one helped adults with acne in a small 12-week trial.

   Pairs with: #8 Low-glycemic

Fungal acne (looks like acne)

Signs: tiny, itchy, same-size bumps on the forehead, chest or back; worse in heat.

1. 15 Ketoconazole or zinc pyrithione wash

   Over the counter Case series

   Fungal acne isn’t acne at all: it’s a yeast (Malassezia) growing in the hair follicles, which gives itchy, same-size bumps on the forehead, chest or back. Acne creams don’t touch it, and antibiotics can make it worse. An anti-dandruff shampoo with ketoconazole or zinc pyrithione, used as a face or body wash, treats the yeast: leave it on for 5 minutes, then rinse. Use it daily for 2 to 4 weeks, then once a week to keep it away.

   • Best for: Itchy, same-size bumps acne creams don't clear
   • How to use: Leave on 5 minutes, rinse; daily for 2 to 4 weeks, then weekly
   • Results in: 2 to 4 weeks
   • Side effects: Dryness
   • Avoid if: Allergy to ketoconazole
   More detail

   Backed by case reports, not trials. Not clear in a month? A doctor can confirm it and prescribe an antifungal pill.

Stronger options with a doctor

Signs: acne that leaves marks or scars, deep painful lumps, or spots still coming after 3 months of the steps above.

1. 16 Tretinoin

   Prescription AAD: strong

   Tretinoin is a stronger prescription retinoid than adapalene. It stops new plugs and, over months, fades marks and smooths skin texture. It is the next step when adapalene hasn’t cleared blackheads and whiteheads after about 3 months. Start every other night with a pea-sized amount; trifarotene is a newer option for the chest and back.

   • Best for: Plugs adapalene didn't clear
   • How to use: Pea-sized, at night
   • Results in: 8 to 12 weeks
   • First weeks: Red spots may flare at first; keep going (FDA label)
   • Side effects: Dryness, sun sensitivity
   • Pregnancy: Avoid (AAD)
   More detail

   Benzoyl peroxide breaks tretinoin down, so use one in the morning and the other at night.

   Pairs with: #1 Benzoyl peroxide

2. 17 Clindamycin with benzoyl peroxide

   Prescription AAD: strong

   This gel combines a topical antibiotic (clindamycin) with benzoyl peroxide. The benzoyl peroxide stops bacteria from becoming resistant to the antibiotic, which is why an antibiotic cream should never be used on its own. It suits red pimples that benzoyl peroxide alone didn’t calm. Expect some dryness, and keep it away from towels and pillowcases, which it can bleach.

   • Best for: Red pimples benzoyl peroxide alone didn't calm
   • How to use: Once or twice a day, as prescribed
   • Results in: 8 to 12 weeks
   • Side effects: Dryness; bleaches fabric
   • Avoid if: Past colitis or bowel disease
   More detail

   Dapsone gel is another prescription option for red spots.

   Pairs with: #2 Adapalene

3. 18 Doxycycline (oral antibiotic)

   Prescription AAD: strong

   Doxycycline is a pill that calms moderate to severe red acne, usually within 4 to 8 weeks. Guidelines keep it to about 3 to 4 months, always together with benzoyl peroxide and a retinoid, which keep skin clear after the pill stops and stop bacteria from growing resistant. It makes you burn more easily in the sun, so wear sunscreen. It isn’t used in pregnancy or for children under 8.

   • Best for: Moderate to severe red acne
   • How to use: Daily pill, 3 to 4 months at most
   • Results in: 4 to 8 weeks
   • Side effects: Sunburn, upset stomach
   • Avoid if: Pregnancy, under 8
   More detail

   Pairs with: #1 Benzoyl peroxide

4. 19 Isotretinoin

   Prescription AAD: strong

   Isotretinoin shrinks the oil glands and is the only acne drug that works on all four parts of a pimple: oil, plugs, bacteria and inflammation. It is for cysts, scarring, or acne that nothing else cleared, and many people need only one 4 to 6 month course. Dry lips and skin are almost certain, and any mood changes should be reported to your doctor. Because it causes birth defects, everyone in the US enrolls in the FDA’s iPLEDGE program.

   • Best for: Cysts, scarring, or acne nothing else cleared
   • How to use: Daily pill, 4 to 6 months, monthly checks
   • Results in: A 4 to 6 month course
   • Side effects: Dry lips and skin, nosebleeds; report mood changes
   • Avoid if: Pregnancy (iPLEDGE: two birth control methods)
   More detail

   Pairs with: #20 Cortisone shot

5. 20 Cortisone shot

   With a doctor AAD: good practice

   For one large, painful cyst, a dermatologist can inject a small dose of diluted cortisone straight into it. It usually flattens within a few days and lowers the risk of a scar, which helps before an event or when a cyst won’t settle. It treats that one spot, not acne overall. For a smaller spot, try the safe home steps on how to get rid of pimples.

   • Best for: One large, painful cyst you need gone fast
   • How to use: One small injection, at a dermatologist
   • Results in: Usually flatter within a few days
   • Side effects: Rarely a small dent that fades
   More detail

   For scars, a dermatologist can also offer peels and laser.

   Pairs with: #19 Isotretinoin

Best acne treatments at a glance

#	Treatment	Best for	Kind	Price
Start here: treat the spots you see
1	Benzoyl peroxide	Red pimples	OTC	about $11 for 6 oz
2	Adapalene 0.1%	Blackheads, whiteheads	OTC	about $25 to $30 for 45 g
3	Salicylic acid	Oily skin, body acne	OTC	about $12 to $14 for 8 oz
4	Azelaic acid	Dark marks, pregnancy	OTC or Rx	about $12 for 30 ml
Cause: hormones
5	Clascoterone 1% cream	Hormonal acne, any sex	Rx cream	depends on your insurance
6	Spironolactone	Adult women, jawline	Rx pill, women	depends on your insurance
7	Combined birth control pill	Flares that follow a monthly cycle	Rx pill, women	depends on your insurance
Cause: lifestyle (diet and deficiencies)
8	Low-glycemic eating	Worse after sweets	Kitchen	free
9	Switching to A2 milk	Worse with skim milk or whey	Kitchen	free
10	Omega-3 fats	Inflamed spots	Kitchen or OTC	free
11	Zinc	Inflamed acne	OTC supplement	a low-cost supplement
12	Vitamin D	Low vitamin D	OTC supplement	a low-cost supplement
Cause: stress and sleep
13	Steady sleep and stress relief	Stressful weeks	Habit	free
Cause: the gut
14	Fiber and fermented food	Bloating, irregular digestion	Kitchen or OTC	free
Fungal acne (looks like acne)
15	Ketoconazole or zinc pyrithione wash	Fungal acne	OTC wash	about $16 to $20 for 7 oz
Stronger options with a doctor
16	Tretinoin	Plugs that stay	Rx cream	depends on your insurance
17	Clindamycin with benzoyl peroxide	Stubborn red pimples	Rx gel	depends on your insurance
18	Doxycycline (oral antibiotic)	Moderate red acne	Rx pill	depends on your insurance
19	Isotretinoin	Cysts, scars	Rx pill, iPLEDGE	depends on your insurance
20	Cortisone shot	One big, painful cyst	Dermatologist	depends on your insurance

US prices for one pack, checked November 2026; prescription costs depend on your insurance.

How to combine the best acne treatments in one routine

An acne routine pairs skin treatments for the spots you see with one inside change for the cause. Start each new active two or three nights a week; a moisturizer fixes most dryness.

Morning and evening acne routine, skin and inside

Step	Morning	Evening
1. Clean	Gentle cleanser, lukewarm water, fingertips	Remove makeup and sunscreen, then cleanse
2. Treat	Benzoyl peroxide or azelaic acid	Adapalene or your prescription retinoid, pea-sized
3. Moisturize	Oil-free, non-comedogenic	The same, or richer if peeling
4. Protect	Sunscreen SPF 30 or higher	none

Three mistakes keep acne coming back: popping spots, switching products after two weeks, and stopping when spots fade. If skin stings, keep retinoids and acids on separate nights.

Best acne treatments by severity

Dermatologists grade acne from 0 (clear) to 4 (severe). The grade sets how strong a treatment you need.

Treatment ladder by acne grade

Grade	What you see	Start with	Dermatologist
0 to 1 Almost clear	A few blackheads or whiteheads	#2 or #3	Not needed
2 Mild	Plugs plus some red pimples	#1 with #2	If no change in 2 to 3 months
3 Moderate	Many red pimples, a few deeper	#16, #17; #18 or #6 for a while	Yes
4 Severe	Nodules, cysts, scars	#19; #20 for single cysts	Yes, soon

See a dermatologist for cysts, scarring, no change after 2 to 3 months, or acne that hurts your mood. True scars are treated with laser, microneedling or subcision.

Reader questions

Short, plain answers to what people ask most.

What are the 5 main causes of acne?

Extra oil, plugged pores, acne bacteria and inflammation. Behind them sit hormones, diet, stress and the gut.

What clears up acne immediately?

Nothing clears acne in a day. For one spot, a pimple patch overnight; for a big cyst, a dermatologist's cortisone shot.

Do tea tree oil and other natural options help acne?

A little. A 5% tea tree oil gel worked about as well as 5% benzoyl peroxide in one trial, only slower. A 4% niacinamide gel matched clindamycin gel in another; clay and herbal masks have only small, uncontrolled studies.

What foods trigger acne?

Studies link skim milk, whey protein and high-sugar diets to acne; chocolate’s link is weak and unclear. Diet rarely clears acne on its own.

Sources

1. Reynolds RV et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol 2024;90(5):1006.e1, e30 (PMID 38300170)
2. American Academy of Dermatology: Acne diagnosis and treatment
3. American Academy of Dermatology: When acne won't clear
4. American Academy of Dermatology: Hormonal therapy for acne
5. American Academy of Dermatology: Acne treatment during pregnancy
6. American Academy of Dermatology: Are your hair care products causing breakouts?; I have acne! Is it okay to wear makeup?; Is that stubborn acne really acne?
7. FDA: Differin Gel 0.1% approved for over-the-counter use, 2016; clascoterone (Winlevi) approval and label, 2020; clindamycin and benzoyl peroxide gel label; doxycycline label; iPLEDGE REMS
8. NIH Office of Dietary Supplements: Zinc fact sheet for health professionals
9. Mills OH et al. Comparing 2.5%, 5%, and 10% benzoyl peroxide on inflammatory acne vulgaris. Int J Dermatol 1986
10. Smith RN et al. A low-glycemic-load diet improves symptoms in acne vulgaris patients. Am J Clin Nutr 2007
11. Adebamowo CA et al. High school dietary dairy intake and teenage acne. J Am Acad Dermatol 2005
12. Lim SK et al. Comparison of vitamin D levels in patients with and without acne: a case-control study combined with a randomized controlled trial. PLoS One 2016
13. Rubenstein RM, Malerich SA. Malassezia (Pityrosporum) folliculitis. J Clin Aesthet Dermatol 2014
14. Jianqin S et al. Effects of milk containing only A2 beta casein versus milk containing both A1 and A2 beta casein proteins on gastrointestinal physiology. Nutr J 2016
15. Silverberg NB. Whey protein precipitating moderate to severe acne flares in 5 teenaged athletes. Cutis 2012
16. Chiu A et al. The response of skin disease to stress. Arch Dermatol 2003
17. Fabbrocini G et al. Supplementation with Lactobacillus rhamnosus SP1 normalises skin expression of genes implicated in insulin signalling and improves adult acne. Benef Microbes 2016
18. Jung GW et al. Prospective, randomized, open-label trial comparing an acne treatment regimen with and without a probiotic supplement. J Cutan Med Surg 2013
19. Jung JY et al. Omega-3 fatty acid and gamma-linolenic acid in acne vulgaris. Acta Derm Venereol 2014
20. Dreno B et al. Multicenter randomized comparative study of zinc gluconate versus minocycline. Dermatology 2001
21. Yee BE et al. Serum zinc levels and efficacy of zinc treatment in acne vulgaris: a systematic review and meta-analysis. Dermatol Ther 2020
22. Kazandjieva J, Tsankov N. Drug-induced acne. Clin Dermatol 2017
23. Shalita AR et al. Topical nicotinamide compared with clindamycin gel. Int J Dermatol 1995
24. Tea tree oil versus benzoyl peroxide trial (Med J Aust, 1990), PMID 2145499; NCCIH: Tea tree oil

This page is general information, not a diagnosis. See a dermatologist if you have deep cysts or nodules, scarring, over-the-counter products haven't helped after 2 to 3 months, or you're pregnant and want treatment.