Updated: Feb-23-2021

Over-The-Counter Acne Products: What Works and What Doesn't

By - Reviewed by CHD Team
Discover the common active ingredients found in OTC acne products and how they work to treat acne.
Acne Products
What to look for in a acne product. Shutterstock Images

Acne is arguably the most common dermatologic disease worldwide[1]. It is often seen in adolescents, but it also affects people of all ages. Those who suffer from this terrible, embarrassing disease tend to seek both prescription and over-the-counter (OTC) solutions, although the latter seem to be popular nowadays.

What are Over-The-Counter Acne Products?

OTC acne products, as the name suggests, pertains to non-prescription skincare products intended to combat acne. The amount of OTC acne products in the market today are overwhelming but in general, they can be classified into five major groups[2] - 1) cleansers, 2) leave-on products, 3) vitamins, 4) essential oils, and 5) mechanical treatments.

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Reasons for Taking Over-The-Counter Acne Products

OTC acne products are usually preferred by many because they are convenient, more affordable, and doesn't require any visit to the dermatologist. These products get rid of acne by targeting at least one mechanism involved in the formation of acne lesions. These products work to:

  • Decrease and normalize sebum production[3]
  • Correct abnormal keratinization[4]
  • Stop the proliferation of acne-causing bacteria[5]
  • Reduce inflammation

Over-The-Counter Acne Products - Key Ingredients to Look For

The most effective OTC acne products are said to contain any of the following key ingredients:

  • Benzoyl Peroxide - This organic acid is one of the most popular choices when it comes to acne treatment, be it prescription or OTC products. It works by exfoliating the skin[6], dissolving whiteheads and blackheads, and reducing the amount of acne-causing bacteria. Acne products containing benzoyl peroxide are available in various concentrations ranging from 2.5-10% and often combined with an antibiotic for more pronounced improvements.
  • Glycolic Acid - A type of alpha-hydroxy acid[7], it also works by exfoliating the skin and inducing collagen production within the dermis. Regular use of this acid results in increased skin thickness, which is attributed to increased amount and quality of collagen and elastic fibers.
  • Salicylic Acid - A type of beta-hydroxy acid and the only one of its kind used in dermatological products. It is commonly found in many acne cleansers, toners, and lotions. Like the first two ingredients, it induces exfoliation[8] and also exerts some whitehead- and blackhead-dissolving effects. OTC acne products containing salicylic acid has concentrations ranging from 0.05-0.5%. Higher concentrations are also available, but they are reserved for prescription acne products and chemical peels.
  • Tea Tree Oil - This essential oil originated from Australia and has been used for decades in treating various infections due to its potent antibacterial[9] and antifungal properties[10]. Acne-causing bacteria has been reported to be sensitive to this oil. Tea tree oil is said to be as effective as benzoyl peroxide in treating mild to moderate acne, although the latter has a faster onset of action while the former has fewer side effects.
  • Retinol - A derivative of vitamin A that exists both in natural and synthetic forms. They work by stimulating cell proliferation[11] and differentiation. This may sound counterintuitive, but it actually produces a normalizing effect of hyperproliferative cells. Other functions of retinol include inhibiting sebum production and reducing inflammation.

Do Over-The-Counter Acne Products Work?

Majority of OTC acne products are not supported by clinical studies. The ones with scientific backing are often evaluated by studies that were funded by the manufacturers. This is not to say that they are ineffective, because some of them are actually approved and prescribed by dermatologists. In addition, their popularity may also suggest how effective they can be.

How to Choose the Best Over-The-Counter Acne Products?

Although they are not prescription products, choosing an OTC acne product must still be supervised by a dermatologist especially if you have severe acne and/or are using medications. It is also advised that you start with products that have low concentrations and be patient enough to wait for the results. Treatment of acne takes time and the problem may actually get worse at first before it clears up.

The Bottom Line

When it comes to treating acne, most people rely on OTC acne product first rather than go to their dermatologist. In addition to being more accessible, affordable, and convenient, most of the key ingredients are actually ones that dermatologists would prescribe.

Nonetheless, since these OTC products aren't strongly supported by scientific studies, it is recommended that you ask your dermatologist regarding which acne products could work depending on the severity of your acne, as well as to help formulate a proper treatment regimen and determine any potential interactions with your other acne medications.

**This is a subjective assessment based on the strength of the available informations and our estimation of efficacy.

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