10 Powerful Ingredients That Can Zap Acne Wherever It Lives

And what you can do to stay protected.

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Adapalene

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There are numerous dermatologist-approved ways to treat breakouts, and now one of their top pimple fighters, Adapalene, has become available over-the-counter as Differin Adapalene Gel. Adapalene is a synthetic, prescription-grade retinoid that doctors have been using for over 20 years. "Topical retinoids are the best ingredients for unclogging pores and helping bring new skin cells to the surface, while shedding old ones," explains Tsippora Shainhouse, MD, Beverly Hills-based dermatologist. "Regular use of these over-the-counter retinols can help with skin texture, acne, and the appearance of scars."  

Salicylic acid

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Found in many cleansers and moisturizers, this beta hydroxy acid helps to unstick skin cells and exfoliate the skin. "Salicylic acid can help greasy skin, but can be hard on drier or sensitive, acne-prone skin types," explains Dr. Shainhouse. "For adult skin, limit salicylic acid washes to twice a week on the face, and stick with using them for unclogging the pores on the back and chest to prevent and dry up body acne." She also recommends an on-the-spot gel formula for overnight use on new inflammatory lesions to help dry them up by the morning (try m-61 PowerSpot Clear). Adults should consider the alpha hydroxy acid glycolic acid, a chemical exfoliant that works in a similar way but may be gentler on more mature skin. (Try a 5 percent glycolic acid product such as NeoStrata’s Foaming Glycolic Wash.) 

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Sulfur washes, creams, and masks

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"Sulfur is keratolytic, so it helps exfoliate skin and possibly unclog pores," explains Dr. Shainhouse. "It is antibacterial and can help mattify skin, by 'mopping up' oil and sebum. It also inhibits pro-inflammatory enzymes, thus reducing inflammation and minimizing the development of new acne lesions." (Try Dr. Dennis Gross Clarifying Colloidal Sulfur Mask and Tata Harper Clarifying Spot Solution.) The cons: It's not the strongest treatment, and it can cause mild irritation and dryness in sensitive skin. Make sure you don't fall for any of these acne myths. 

Benzoyl peroxide

 via xout.com

This ingredient acts as a bleach by oxidizing and killing the bacteria that can cause acne. "Benzoyl peroxide can be used on the face, chest, and back," says Dr. Shainhouse. (Try X OUT, an 8.5 percent benzoyl peroxide cleanser, spot treatment, and mask by the Makers of Proactiv.) Just be wary of bleaching fabric, as the peroxide can bleach clothing, towels, and even hair. Also, although it's very effective when used with other topical or oral acne medications, it can be drying and irritating to adult skin. "While a wash-off cleanser can be easier to use, topical creams, including prescription versions, may be more effective." These are the 11 myths about large pores everyone must know.

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Intralesional steroid injections

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This is the same treatment that actress Olivia Munn sought out when she experienced cystic acne. "Steroid injections can be useful to treat painful, tender, inflamed, and indurated subcutaneous nodules that pop up," says Dr. Shainhouse. "We use a tiny injection of dilute steroid to reduce the inflammation within a day, and help speed the healing of the acne lesion or cyst." 

Oral antibiotics

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"When taken at normal doses for two to three months and used in conjunction with topical medications, prescription antibiotics can significantly reduce acne lesion count and severity in teens and some adult patients," says Dr. Shainhouse. However, they are not meant to be taken long-term at this dose. "Low-dose oral tetracyclines do not kill bacteria, but rather, help block the pro-inflammatory enzymes in the skin that lead to inflamed, red acne lesions and tender cysts in some adult women." These can be taken longer term. Don't miss these super-important questions to ask before taking prescription medications.  

Oral Isotretinoin (aka Accutane)

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This is an oral version of tretinoin (Retin A) that works by temporarily shrinking oil glands (they grow back after treatment, so your skin doesn't stay clear forever) and training the lining of the pores to produce and express their keratinocytes and keratin, to prevent clogging. "This is usually a five-to-six-month treatment course," says Dr. Shainhouse of the prescription medication. "For many patients, their skin remains perfectly clear, or almost clear, forever." However, women should avoid this treatment during pregnancy, she adds, due to the risk of birth defects. These are the clear signs you need prescription acne treatment.

Spironolactone

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Spironolactone is a prescription diuretic pill that has anti-androgenic side effects, meaning it counteracts the effects of male sex hormones such as testosterone on the skin (yes, even women make testosterone—just much less than men). "Classically used to manage high blood pressure, Spironolactone can be very helpful in managing cystic acne in women who flare with their menstrual cycle," says Dr. Shainhouse. "It is frequently used to manage acne and other androgenic signs in women with Polycystic Ovarian Syndrome (PCOS)." As in the case with PCOS, your acne may even be trying to tell you something important. (Do not take this medication if you are pregnant.)

Oral contraceptive pills

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By helping maintain estrogen and progesterone hormone levels in the blood, birth control pills can actually reduce premenstrual acne flares. It is important to note, however, that the opposite can be true when taking high-progesterone or low-estrogen formulations of birth control. "Depo-provera shots and hormonal IUDs do not contain estrogen and may trigger acne flares when initiated," says Dr. Shainhouse. These are the things you must know about birth control, according to doctors. 

Blue light therapy

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"Blue light has been shown to kill P.acnes bacteria and may help reduce inflammation in and on the skin," explains Dr. Shainhouse. It can be administered twice a week for four to six weeks at your dermatologist's office or for five minutes a night at home with a hand-held device that can be purchased over the counter, such as reVive Light Therapy Spot Acne Treatment. Your dermatologist may apply a skin-sensitizing, topical prescription medication on your skin before the treatment to increase the efficacy of the treatment. "Light therapies that use blue and red light may help also calm acne."