Breakouts: What Actually Helps

Three over-the-counter ingredients have real evidence behind them for acne, and most shelf products that work contain one of them. Everything else is a supporting act. The mistakes people make are using too much too fast, using several at once, and picking, which on deeper skin leaves marks that outlast the breakout by months.

The three that work

Benzoyl peroxide kills the bacteria involved and is the most effective for inflamed, red spots; it bleaches fabric, so use white towels and pillowcases. Salicylic acid dissolves the oil and dead skin that block pores and suits blackheads, congestion and oily skin. Adapalene, a retinoid available over the counter, keeps pores clear and prevents new spots, and it is the closest thing to a long-term fix on the shelf. Each does something different, and a routine built around one or two of them, used consistently, outperforms a shelf of products used randomly.

Go slow

Every one of these irritates skin at first. Start with the lowest strength, apply every other night, and build up over weeks. Dryness, peeling and redness in the first two weeks is the product working, not failing, and stopping at that point is the most common reason people say nothing works. Use a plain moisturizer alongside, and sunscreen in the morning, since all three make skin more sun-sensitive.

Do not pick

On deeper skin, the mark left by squeezing a spot is usually darker and longer-lasting than the spot itself. Hydrocolloid patches over a whole spot draw it out without damage and stop you touching it. If a spot is under the skin and not ready, leave it; forcing it creates inflammation that becomes a mark.

What around it helps

A gentle cleanser rather than a harsh one, because stripped skin produces more oil. An oil-free moisturizer, since skipping it makes oily skin oilier. Clean pillowcases, clean phone screens, and keeping hair products off the forehead and hairline, which are a common overlooked cause of breakouts along the edges of the face, particularly under a bonnet.

When to see a doctor

Painful, deep, cystic spots that never come to a head. Breakouts that leave pits or raised scars. Acne that has not responded to three months of a consistent over-the-counter routine. Sudden severe breakouts in an adult. A dermatologist has prescription retinoids, antibiotics and other options that are considerably more effective, and the earlier scarring acne is treated the less permanent damage it leaves.