Treating acne can be a months-long exercise in patience finding the right set of products for your skin. We read the double-blind studies, then talked to dermatologists and aestheticians to see which kits have the right combination of salicylic acid and benzoyl peroxide to really work–and not make your acne worse. Keep on reading to see what the best acne treatment is.
*Post originally featured on Reviews.Com
The Best Acne Treatment: Walk Thru + Must-Have Products
Nobody thinks popping pimples is a good idea. But’s it’s so satisfying–mostly because you can actually see something happening. Contrary to the marketing promises of “blemish banishers” and “zit zappers,” immediate results are not the trademark of acne treatment, a frustrating truth to anyone suffering through a breakout. And while pimples are personal (your stress-induced spots will look and act differently than your best friend’s breakout), the best acne treatments will include a regimen of products to hit all of acne’s root causes. Our top pick, Paul’s Choice Regular Strength Clear Acke Kit, is a 3-part system designed to unclog pores, heal breakouts, and soothe redness.
Acne vulgaris is the catch-all term for everything from angry red lesions to tiny white bumps, which are the results of hair follicles and their sebaceous glands becoming blocked and inflamed–how vulgar indeed. Genetics plays a big part in who gets acne and how severely, but each blemish can be blamed on some combination of sebum production, a bacteria called Propionibecterium acnes (P. acnes), plugged follicles, and inflammation. Finding a good treatment is really about finding the right combination of ingredients to troubleshoot each of those issues.
How We Found the Best Acne Treatment
Our first plan was to look at it all–spot treatments, washes, scrubs, and creams–until we learned that when it comes to over-the-counter treatments, there is no one single cure. A 2013 study on acne vulgaris in The Nurse Practitioner concurred that, in most cases, a multidimensional approach to acne is necessary because most people have a combination of symptoms. On the advice of dermatologists and aestheticians, we turned our focus to regimen sets, analyzing the ingredients of more than 40 kits before finding our top picks.
Keep in mind that even if some products market themselves toward severe acne breakouts, all the kits we looked at are definitely designed for mild to moderate acne. Dr. Lawrence Green, board-certified dermatologist and assistant clinical professor of dermatology at George Washington university, warms that even moderate acne can be beyond what an over-the-counter treatment can handle, and recommends seeing a specialist. Granted, if you’re in the middle of a breakout, every pimple seems pretty severe (and if your acne feels out of control, you might be desperate to try anything). Good thing the Journal of Clinical and Aesthetic Dermatology published a study to determine if people could self-diagnose their level of acne. The researchers found that, with this handy chart, you can!
We looked for kits with at least 2 active ingredients proven to fight acne.
There are two big guns used to take down acne (and a few little Berettas), and they are both great at doing entirely different things. Salicylic acid is a beta hydroxy acid that comes from willow bark, which is just to say that it’s naturally occurring and works primarily as an exfoliator, breaking down fatty acids like sebum so your pores don’t clog. (Glycolic acid works similarly, but is less effective.) These acids do their thing on comedones–whiteheads, blackheads, and other non-red bumps.
Benzoyl peroxide attacks the P. acnes bacteria. Once it’s on your face, benzoyl peroxide breaks into oxygen and benzoic acid, which rip through the bacteria’s membranes. Sulfur and azelaic acid are less common and less severe alternatives to benzoyl peroxide, which can sometimes leave skin dry and irritated. “I use sulfur-based treatments a lot in adults,” says Dr. Peter Lio, assistant professor of clinical dermatology at Northwestern University. “It’s a good fit for patients who can’t tolerate the side effects of benzoyl peroxide.” All three of these ingredients go after those big red pimples.
The Journal of Clinical and Aesthetic Dermatology states that salicylic acid and benzoyl peroxide are by far the most common acne ingredients and they’re effective in double-blind studies of patients with mild-to-moderately severe acne. The journal also emphasizes glycolic acid and triclosan, a disinfectant that works alongside benzoyl peroxide. We looked for kits that included at least one ingredient targeting each camp: the comedones and the pimples.
Simple alcohols were an automatic cut.
Isopropyl alcohol, SD alcohol, and denatured alcohol are everywhere in acne treatment because they trick you into thinking they’re working: Splash some on and any oil on your face instantly vaporizes. (Granted, there are other less nefarious reasons for alcohol too, such as helping Vitamin C penetrate the skin.)
Simple alcohols destroy the skin’s barrier, called the acid mantle, which is what keeps your skin’s pH in its happy place (and your skin blemish-free). “A lot of products that are marketed to treat acne do not maintain–or even consider the importance of–the skin’s acid mantle,” explains Natarsha Bimson, a Los Angeles-based aesthetician. “It’s a huge issue.” In one study, even a small, 3 percent alcohol solution applied to skin cells over the course of two days increased cell death by 26 percent–in some acne treatments, like Kate Somerville’s EradiKate, alcohol makes up the majority of the treatment.
When your acid mantle is damaged, you’re actually more susceptible to breakouts, enlarged pores, and inflammation (aka acne). To make matters worse, evaporating all the oil on your face can actually set your sebaceous glands into overdrive, leaving your skin oilier than ever. Talk about counterproductive. If any product included a simple alcohol high up in its ingredients list, we nixed its whole kit.
We eliminated kits with benzoyl peroxide spot treatments.
Spot treatments are designed to give problem pimples a mega-dose of concentrated benzoyl peroxide–in a couple of regimens, like the Proactiv Teen Kit, the spot treatment had nearly three times the benzoyl peroxide as its all-over treatment. It makes sense: If benzoyl peroxide can be irritating to the skin in high concentration, limits its intensity to just the pimple itself could save the rest of your healthy skin.
But the side effects of targeted spot treatments aren’t always worth it. “So many products instruct consumers to use benzoyl peroxide to spot treat red bumps and pustules. I don’t recommend it,” says Dr. Green. “Benzoyl peroxide, when placed on red spots, can actually cause more irritation and inflammation to the area. It’s best used to prevent red bumps and pustules, and applies all over the area you want to treat.” Robin Townsend a medical asesthetician based in Cincinnati, was also quick to naysay a spot-treat-only approach: “Acne affects all of the pores. If someone is going to spot treat against my advice, I still suggest they spot treat one day and treat the whole face the next.”
With six acne treatments left in the running, we dug deeper into their ingredients and went through the regimenes to find which ones worked hard on acne, yet felt great on the skin.
Our Picks for the Best Acne Treatment
Best Overall: Paula’s Choice Clear Regular Strength System
This system might not have the most products. And its percentage of active ingredients may not be the highest. But this twice-daily three-step kit–which includes a cleanser, an anti-redness exfoliant, and a leave-on treatment–is concise without cutting corners.
Runner Up: Proactiv+ 3-Step System
Proactiv offers a number of kits, but this is the one to get–the combo of benzoyl peroxide and salicylic acid will provide a solid one-two punch. All of Proactiv’s regimens are heavy on the benzoyl peroxide, and the Proactiv+ three-step kit is no different: a 2.5 percent benzoyl peroxide wash, a 2.5 percent benzoyl peroxide gel, and a 0.5 percent salicylic acid moisturizer.
Dermalogica Clear Start Kit
Dermalogica sells its full-size Clear Start products a la carte (all at around $20–this line is definitely not made for the thrift) and there are even more options than the five in the travel kit. The products themselves are gorgeous, with a mix of salicylic acid and benzoyl peroxide, plus all-natural heavy hitters like tea tree oil and witch hazel. Even better: In addition to the wash, toner, moisturizer, and treatments, the kit includes an acne-safe (read: oil-free) sunscreen in its lineup.
Neutrogena Complete Acne Therapy System
This three-piece set scores points for including sunscreen, but misses the mark with its Skin Polishing Acne Cleanser. it’s the only product in the kit wtih salicylic acid, and you end up washing it all off anyway. A recent “formula improvement” in the acne control lotion has left cusomers leaving less-than-pleased comments on the Neutrogena website too.
Read the full treatment set reviews here.
The Bottom Line
We love Paula’s Choice Regular Strength Clear Acne Kit for its balance of active and inactive ingredients–plus the option to upgrade to an Extra Strength version–but you may have to experiment to find out what works best for your breakouts. Wee recommend trying something new if you don’t see improvement after six weeks.
Take stock of your spots. Are your blemishes a majority of red pimples or white bumps? For the former, tailor your regiment with benzoyl peroxide-heavy ingredients list, like Proactiv+ 3-Step System. For the latter, Paula’s Choice will be a better place to start.
Check the labels on your makeup. Acne treatments can be made moot if you pile on pore-clogging cosmetics. Look for labels that state non-comedogenic.
Talk to a skincare pro. If your acne is severe, painful, or refusing to get lost, you may just be beyond what an over-the-counter treatment can do. Not only an a professional set you up with the really powerful stuff, but also Fitz Patrick explains that “working closely with an aesthetician or dermatologist means you can keep tweaking a routine to make it work best for you.”