For those of you with acne, we have good news and bad news. The bad news: acne treatments take time to work. The good news: dermatologists are on it.

Acne is a complex skin condition with multiple causes—different types of acne respond to different types of treatments. To help you make sense of all the options out there, we’ve compiled a list of research-backed acne treatments and skincare ingredients recommended by medical experts. 

These are 12 of the most effective treatments recommended by medical experts for acne. 

1. Tretinoin 

Dermatologists widely consider tretinoin to be the gold standard in topical acne treatment. It’s a potent vitamin A derivative (aka retinoid) used to treat both acne and signs of aging. Only available by prescription, tretinoin treats acne by helping the skin generate new skin cells and shed old ones. Healthy cell turnover helps keep your pores unclogged (in turn helping prevent acne), reduce fine lines, improve skin texture, and fade hyperpigmentation like sun spots or post-inflammatory marks. 

What it is: Tretinoin is a retinoid, or vitamin A derivative, used to treat acne and signs of aging. 

• Influences the way skin generates new skin cells and sheds old ones

• Helps unclog pores by regulating cell generation

• Helps reduce fine lines and improve skin texture

• Helps fade hyperpigmentation like sun spots or post-inflammatory marks 

Tretinoin treatments at a glance:

• Products: Prescribed in topical creams or gels, including the brand names Retin-A, Retin-A Micro, and Tretin-X—plus, some formulations of Curology’s Custom Formula

• Availability: By prescription only 

• Types of acne treated: All

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2. Adapalene 

Adapalene (commonly known by the brand name Differin) is a topical retinoid available by prescription and over-the-counter. In general, adapalene is less irritating than tretinoin. It also tends to be more photostable (aka less likely to be degraded by the sun).

What it is: Adapalene is a topical retinoid available by prescription and over-the-counter (depending on the formulation). You may recognize it by the brand name Differin.

• Influences the way skin generates new skin cells and sheds old ones 

• Works similarly to tretinoin

• Can generally be used in either the morning or night (although Curology typically recommends nighttime use to be safe!)

Adapalene treatments at a glance:

• Products: Found in topical gels, creams, and lotions such as Differin (brand name) and generic adapalene 

• Availability: By prescription and over-the-counter

• Types of acne treated: All

3. Zinc pyrithione 

Zinc pyrithione can help treat ordinary acne as well as acne caused by pityrosporum, a type of fungus that normally occurs on the skin and can cause fungal breakouts (aka folliculitis). Zinc pyrithione cleansers and soaps can help fight acne-causing fungus and bacteria. 

What it is: Zinc pyrithione is an antifungal ingredient found in cleansers and soaps. 

• Influences your skin’s microbiome

• Has mild anti-inflammatory effects

• May help reduce oiliness

Zinc pyrithione treatments at a glance:

• Products: Found in various soaps and cleansers (in addition to certain formulations of the Curology Custom Formula)

• Availability: Over-the-counter

• Type of acne treated: All types — including fungal acne

4. Benzoyl peroxide 

Benzoyl peroxide is a topical antimicrobial with a mild anti-inflammatory effect. It’s one of the most common over-the-counter ingredients used in skincare products to treat acne. Benzoyl peroxide is especially common as an active ingredient in spot treatments, cleansers, and body washes. 

What it is: Benzoyl peroxide helps treat acne with antimicrobial properties, making it an alternative to or addition to antibiotic treatments. 

• Influences your skin’s microbiome

• Has mild anti-inflammatory effects

• Can help unclog pores 

Benzoyl peroxide treatments at a glance: 

• Products: Found in spot treatments, creams, and cleansers, such as La Roche-Posay’s Effaclar Duo Acne Spot Treatment, CeraVe Acne Foaming Cleanser, and Neutrogena’s Stubborn Acne Spot Gel 

• Availability: Over-the-counter

• Type of acne treated: All 

5. Salicylic acid

Salicylic acid is a chemical exfoliant that helps shed dead skin cells. Also known as beta hydroxy acid (BHA), salicylic acid is oil-soluble, so it penetrates through sebum and into pores to help clear them. That ability makes salicylic acid effective in treating blackheads, whiteheads, and other types of acne. 

What it is: Salicylic acid is a BHA used to unclog pores. 

• Exfoliates the skin

• Can help reduce oiliness 

• Frequently found in many skincare products

Salicylic acid treatments at a glance: 

• Products: Found in cleansers, toners, serums, and wipes, including Curology’s acne body wash and CeraVe’s Renewing SA Cleanser

• Availability: Prescription and over-the-counter

• Type of acne treated: All, but especially blackheads and whiteheads 

6. Azelaic acid 

Azelaic acid is a naturally occurring dicarboxylic acid found in barley and rye. It’s used to treat acne, rosacea, melasma, and post-inflammatory hyperpigmentation (those dark spots sometimes mistaken for acne scars). Azelaic acid has antimicrobial and anti-inflammatory properties that treat acne by keeping acne-causing bacteria and fungus in check. 

What it is: Azelaic acid is an antimicrobial used to treat uneven skin tone and skin inflammation. 

• Influences your skin’s microbiome 

• Helps treat acne caused by fungus and bacteria

• Regulates melanin production, helping to fade dark spots 

Azelaic acid treatments at a glance:

• Products: Found in prescription topicals, such as Curology’s Custom Formula, Finacea, and Azelex—also available in over-the-counter products like The Ordinary’s Azelaic Acid Suspension 10% and First Aid Beauty’s Skin Rescue Oil-Free Mattifying Gel Moisturizer.

• Availability: By prescription and over-the-counter 

• Type of acne treated: All

7. Clindamycin

Clindamycin is a topical antibiotic acne treatment that targets the acne-causing bacteria living in the skin’s hair follicles (C. acnes). These organisms feed on oil produced by sebaceous glands, and their byproducts can trigger inflammation, often resulting in deep, painful acne lesions. Clindamycin is a prescription-only ingredient and should be used in combination with other skincare ingredients like tretinoin, benzoyl peroxide, or azelaic acid. 

What it is: Clindamycin is a topical antibiotic that treats acne and should be used with other skincare ingredients. 

• Influences your skin’s microbiome 

• Helps treat acne caused by bacteria

• Antiinflammatory effect

Clindamycin treatments at a glance:

• Products: Prescribed in topical creams or gels under brand names such as Cleocin T, Clindagel, and Clindamax or as generic ​​clindamycin

• Availability: By prescription only 

• Type of acne treated: All

8. Spironolactone

Spironolactone can be prescribed as an acne treatment to address hormonal acne in females. If prescribed oral spironolactone, you’ll take a pill that reduces the levels of androgens (a type of hormone). This decreases the oil production in your skin, helping to reduce breakouts. In addition to reducing androgens, it’s also a mild diuretic used to treat high blood pressure.  

What it is: Spironolactone is an oral medication that can help treat hormonal acne.

• Helps reduce levels of androgens

• Decreases oil production caused by androgens 

Spironolactone treatments at a glance: 

• Products: Prescribed as oral medication, including the brand names CaroSpir and Aldactone

• Availability: By prescription only; oral spironolactone should only be prescribed to females  

• Type of acne treated: Hormonal

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9. Ketoconazole

Ketoconazole treats fungal acne by killing microorganisms that fuel breakouts. Additionally, its anti-inflammatory properties can help soothe the skin. If you have fungal acne, ketoconazole may be effective in treating your breakouts. It’s also an ingredient used in various shampoos and other products to help treat other fungal skin conditions such as dandruff. 

What it is: Ketoconazole is an antifungal medication that comes in both topical and oral forms. 

• Influences your skin’s microbiome 

• Helps treat fungal acne by reducing skin inflammation and killing fungus 

Ketoconazole treatments at a glance:

• Products: Found in topical creams (like prescription Ketoconazole Cream 2%), shampoos, and oral medications

• Availability: By prescription and over-the-counter 

• Type of acne treated: Fungal and potentially bacterial acne

10. Birth control pills

Birth control pills provide another option for treating hormonal acne. Certain birth control pills can help reduce acne and oil production, and many of those that contain both estrogen and a progestin can lessen the effects of acne-causing androgens like testosterone. That said, certain types of progestin may make acne worse. Since they can activate androgen receptors, certain progestins can indirectly cause the skin’s oil production to ramp up and breakouts to worsen. 

The U.S. Food and Drug Administration (FDA) has approved four birth control pills for acne treatment: Ortho Tri-Cyclen, Estrostep, Beyaz, and Yaz. Talk to your in-person medical provider to find the best birth control pill for you!

What it is: The combined oral contraceptive pill, often referred to as birth control pills, is a type of birth control that is designed to be taken orally by women. 

• Can influence the production of certain hormones

• Can lessen the effects of acne-causing androgens

• Some birth control pills can make acne worse 

Birth control treatments at a glance: 

• Products: Prescribed as oral medication—FDA-approved birth control pills include Ortho Tri-Cyclen, Estrostep, Beyaz, and Yaz

• Availability: By prescription only 

• Type of acne treated: Hormonal acne

11. Oral antibiotics

For moderate to severe acne, oral antibiotics (including doxycycline, an antibiotic derived from tetracycline) can be used in combination with topical treatment. Exactly how the antibiotic kills acne-causing bacteria depends on the specific medication. Talk to your medical provider to find out if an oral antibiotic is right for you!

What it is: Oral antibiotics should generally be prescribed in combination with topical acne treatments. 

• Influence your skin’s microbiome 

• Target bacteria that causes acne 

Oral antibiotic treatments at a glance: 

• Products: Prescribed as oral medication, including generic doxycycline and the brand names Vibramycin, Oracea, and Doryx

• Availability: By prescription only 

• Type of acne treated: Moderate to severe inflammatory acne

12. Isotretinoin 

Isotretinoin is an oral acne medication that’s a vitamin A derivative (or retinoid). You may have heard of it as Accutane, a brand name that’s now discontinued. Isotretinoin can clear severe or treatment-resistant acne when other treatments fail. Many patients never experience a breakout again (or experience only minimal breakouts) after this treatment. Isotretinoin must be prescribed by an in-person medical provider who can oversee your progress and help you manage potential side effects. 

What it is: Isotretinoin is an oral retinoid used for treatment-resistant acne. 

• Influences your skin’s cell production

• Characterized by intense purging 

• Can often clear acne when other treatments fail  

Isotretinoin treatments at a glance:

• Products: Prescribed as oral medication, including under the brand names Zenatane, Absorica, and Myorisan 

• Availability: By prescription only 

• Type of acne treated: Treatment-resistant, acne that produces physical scarring or significant distress

What about other kinds of acne treatments?

Believe it or not, there are even more options for acne treatment out there. Beyond 12 of the top trusted topicals and pills we dug into above, you might consider an in-office treatment with your in-person dermatology provider. Here are some popular options.

• Chemical peels rapidly exfoliate the skin, allowing dead skin cells to shed more effectively. By removing dead skin cells and excess oil from the hair follicle, pore blockages and pimples can be reduced. More advanced forms of in-office chemical peels can also be used to help reduce the appearance of acne scarring. 

• Light therapy both red and blue LED lights have been used in the treatment of acne, but more research is needed. If you have a dark skin tone, certain light treatments might not be effective for you.

• Hydrafacial is a popular facial that both exfoliates and hydrates the skin. We don’t feel this is a necessity, but it can certainly be a wonderfully soothing treatment.

• Microneedling can stimulate collagen production by creating micro-injuries with tiny needles that prick the skin. While you can use a dermaroller at home, you won’t get the same results as with microneedling in a provider’s office. 

• Vampire Facial combines microneedling and PRP (platelet-rich plasma) to stimulate your body's healing process to treat acne and acne scars. More research is required in order to better understand the risks and benefits of this treatment. 

You may even find an effective treatment outside your medicine cabinet or doctor’s office—many turn to spearmint tea, a dairy-free diet, or liquid chlorophyll (though more research is needed on that one before we can say whether or not it’s beneficial for acne). 

How to find a personalized solution to acne

You may even find an effective treatment outside your medicine cabinet or doctor’s office—many turn to spearmint tea, a dairy-free diet, or liquid chlorophyll (though more research is needed on that one before we can say whether or not it’s beneficial for acne). 

If you’re feeling unsure about what your skin needs to beat breakouts, talking to a dermatology provider can help. You can get started with one at no extra cost when you start your Curology free trial. Just take a quick skin quiz and snap a few selfies and one of our licensed medical providers will evaluate your skin. 

If Curology is right for you, we’ll send you a 30-day supply of your Custom Formula with a mix of active ingredients chosen for your unique skin concerns, plus any of our recommended products, for free—just pay $4.95 (plus tax) to cover shipping and handling. Subject to consultation. Subscription is required.

Written by

Curology Team

Medically reviewed by

Nicole Hangsterfer, PA-C