Adult acne treatment
Dermatologists start with benzoyl peroxide, salicylic acid, a retinoid (adapalene) or azelaic acid, one product for 6 to 8 weeks. If breakouts persist, they add antibiotics, birth control pills or spironolactone, a hormonal treatment for adult acne.
- Women and men
- Pregnancy notes
- Strengths listed
- Sensitive skin
Treatment by situation
All adults
- Start with
- One product with adapalene, benzoyl peroxide (start at 2.5%), salicylic acid or azelaic acid, in a thin layer over the whole area, not just spots, for 6 to 8 weeks.
- If it persists
- No change after 2 to 3 months? See a dermatologist in person or through online acne treatment for a prescription retinoid, an antibiotic or a hormonal treatment.
- Avoid
- A second product during those weeks, harsh scrubs, toothpaste on pimples.
- Watch for
- Fewer breakouts at 4 to 8 weeks and clearing around week 16. Early redness and dryness often ease after a month.
Not sure which product fits you?
Start my analysisWomen
- Start with
- The same one-product plan. Note when you break out: flares in the week before your period point to hormones. Jawline breakouts that follow your cycle respond to hormonal acne treatment.
- If it persists
- Ask a dermatologist about a birth control pill (combined oral contraceptive), spironolactone, or both together.
- Avoid
- Spironolactone without reliable birth control if you could become pregnant. It can cause severe birth defects.
- Watch for
- Birth control pills can take a few months to help. Weight gain, breast tenderness and nausea are common side effects. Spironolactone can cause breast tenderness and painful periods.
See if your breakouts follow a hormonal pattern.
Start my analysisMen
- Start with
- One product, used the same way for 6 to 8 weeks. Shave gently over breakouts.
- If it persists
- A dermatologist can prescribe a retinoid, an antibiotic, or clascoterone, a cream that treats the hormonal causes of acne in males and females.
- Avoid
- Spironolactone is generally a treatment for women. In men it can cause breast growth and erectile dysfunction.
- Watch for
- Helmets, tight collars and straps rubbing acne-prone skin.
Find your likely top cause from a photo.
Start my analysisPregnant or breastfeeding
- Start with
- A talk with a dermatologist before you treat acne on your own. Some products sold without a prescription aren't safe in pregnancy.
- If it persists
- Ask your doctor about prescription azelaic acid, which Mayo Clinic lists as an option during pregnancy and breastfeeding.
- Avoid
- Isotretinoin and spironolactone, which can cause severe birth defects, and tetracycline antibiotics such as doxycycline.
- Watch for
- Options are limited in pregnancy because of side effect risks, so plan every product with your doctor.
Know your acne type before your appointment.
Start my analysisSensitive skin
- Start with
- A 2.5% water-based benzoyl peroxide or adapalene. Creams are less irritating than gels.
- If it persists
- Tell your dermatologist if a retinoid irritated you before. Applying moisturizer first can help, but change your routine only with their advice.
- Avoid
- Scrubs, astringents, toners and masks.
- Watch for
- Dryness, scaling, burning and stinging, which benzoyl peroxide can cause on sensitive skin.
Get a routine matched to sensitive skin.
Start my analysisDarker skin tones
- Start with
- Azelaic acid, which fights acne and fades the dark spots that can follow it.
- If it persists
- See a dermatologist if dark spots appear after acne clears. They signal strong inflammation that products sold without a prescription usually can't treat.
- Avoid
- Unprotected sun, which darkens the spots. Use a noncomedogenic moisturizer with sunscreen.
- Watch for
- Topical retinoids can cause dryness and redness, especially in brown or Black skin. Adapalene may be tolerated best.
Check your severity and likely cause from a photo.
Start my analysisWhy adults get acne
Adult acne is acne that continues past your teens or starts for the first time as an adult (adult-onset acne). It means breakouts in your 30s, 40s or 50s, more often in women than men. The causes of adult acne, per the AAD and Mayo Clinic:
- Fluctuating hormones: pregnancy, perimenopause, menopause, or starting or stopping birth control.
- Stress: it raises androgens, hormones that drive oil glands.
- Family history: a parent or sibling with acne.
- Hair and skin products: look for non-comedogenic, oil-free or "won't clog pores" on labels.
- Medication side effects: corticosteroids, testosterone or lithium, for example. Don't stop; ask the prescriber.
- A medical condition: treating it often clears the acne.
Itchy, same-size bumps on the chest or forehead may be fungal acne instead. Not sure which drives yours? The face analysis names your likely top cause.
Over-the-counter options
Over-the-counter acne treatment is medicine sold without a prescription. It means one active ingredient, used alone for 6 to 8 weeks. The strength of each ingredient is on the label:
- Adapalene 0.1%
- A retinoid that unclogs pores and prevents new breakouts.
- Benzoyl Peroxide 2.5% to 10%
- Kills acne bacteria and clears excess oil and dead skin cells. Low strengths work as well as high ones, so start at 2.5%. It bleaches hair and fabric.
- Salicylic Acid 0.5% to 2%
- Unclogs pores and works best on whiteheads and blackheads.
- Azelaic Acid 10%
- Keeps pores clear, is mildly antibacterial, and fades dark spots (post-inflammatory hyperpigmentation).
- Alpha Hydroxy Acids (Glycolic/Lactic Acid)
- Remove dead skin cells, calm inflamed skin and smooth texture.
Prescription options
Prescription acne treatment is medicine a doctor prescribes when store-bought products haven't worked. It means another wait: most take 4 to 8 weeks to work. The choice of medicine depends on your age and your acne's type and severity.
- Prescription Retinoids
- Tretinoin, tazarotene or adapalene, usually applied in the evening. They raise sun sensitivity.
- Topical or Oral Antibiotics
- Clindamycin on the skin, or doxycycline or minocycline by mouth, paired with benzoyl peroxide and kept short to limit antibiotic resistance.
- Hormonal Treatments
- Birth control pills or spironolactone for women, and clascoterone cream for moderate to severe acne in anyone 12 or older.
- Isotretinoin
- A vitamin A-based pill for severe, nodular acne that other treatments haven't cleared. It can cause severe birth defects, so patients join the FDA's iPLEDGE program.
In the office, a dermatologist can also inject a corticosteroid into a large, painful bump, or do a chemical peel, light therapy or extraction.
Daily care
Daily care is the routine around your treatment. It means less irritation, so you can stick with it. The basics of daily care:
- Cleanse gently
- Wash twice a day with your hands, a mild cleanser and warm water, no scrubs or astringents. Skin should feel clean but soft 15 minutes later.
- Moisturize and protect
- Use a light, noncomedogenic moisturizer with sunscreen. Retinoids and some antibiotics raise sunburn risk; sun darkens leftover spots.
- Hands off
- Picking raises the risk of infection and scarring. Keep phones, helmets and straps off acne-prone skin.
When to see a dermatologist
A board-certified dermatologist is a medical doctor who specializes in skin, hair and nails. It means a real diagnosis, since some rashes only look like acne. See one for:
- No clear improvement after 2 to 3 months
- Deep, painful pimples, or acne that leaves scars
- Dark spots after acne clears
- Sudden, severe acne as an older adult, a possible sign of another health problem
- You're pregnant or trying to get pregnant
Get emergency help if a skin product causes faintness, trouble breathing, a tight throat or a swollen face, lips or tongue.