Retinol also isn’t a quick fix. It takes time to see results (possibly a few months), and it’s something you’ll have to keep using to maintain its benefits.
Dermstore
First Aid Beauty FAB Skin Lab Retinol Serum 0.25 Pure Concentrate
Sephora
Drunk Elephant A-Passioni Retinol Cream
Dermstore
PCA Skin Intensive Clarity Treatment 0.5 Pure Retinol Night
Retinol isn’t the only over-the-counter retinoid out there—or the gentlest. In fact, some experts recommend that those with sensitive skin opt for products containing retinal (also called retinaldehyde) instead of traditional retinol. Like retinol, this compound is a naturally occurring retinoid that the body converts to retinoic acid. And, as SELF explained previously, it has been shown in a few studies to be just as effective as retinol and other retinoids with fewer side effects.
Products to try:
Amazon
MyChelle Dermaceuticals Remarkable Retinal Serum
Amazon
Avene Retrinal .1 Intensive Cream
Dermstore
Obagi Medical Retivance Skin Rejuvenating Complex
Adapalene—often known by the brand name Differin—is a synthetic retinoid that used to be available only via a prescription. But it recently became available over-the-counter, which makes it a great, strong acne medication that you can access without a prescription. And because it’s synthetic, it was formulated to be gentler than other prescription acne medications. For those who’ve graduated beyond over-the-counter retinol but aren’t quite ready for the full intensity of a prescription retinoid, adapalene is a perfect choice.
Products to try:
Ulta
La Roche-Posay Effaclar Adapalene Gel
Warning: Sulfur smells like rotten eggs. But it is an effective ingredient at drying up pus-filled pimples and whiteheads (you’ve gotta take the good with the bad). It works by sucking up the oil. Sulfur is typically mixed with other active ingredients to get the most efficacy and with fragrances to mask the strong scent. You can often find it in masks and spot treatments.
Products to try:
Dermstore
Lancer Skincare Clarifying Detox Mask
Sephora
Peter Thomas Roth Therapeutic Sulfur Acne Treatment Mask
This ingredient, which is a plant-based extract often billed as a retinol alternative, is not actually a retinoid at all. But in a few limited studies on Bakuchiol, it did show promise in managing things like skin texture and fine lines—without the side effects we usually associate with retinoids. Today it might show up in a product all on its own or be paired with a low concentration of retinol to help boost the acne-fighting and antiaging effects without increasing the risk for side effects. As a solo ingredient, Dr. Adotama recommends it to those looking for more natural remedies for acne. Bonus: recent research indicates it’s particularly well suited for acne on skin of color.
Target
Versed Press Restart Gentle Retinol Serum
Ulta
Indeed Labs Bakuchiol Reface Pads
Sephora
The Inkey List Bakuchiol Retinol Alternative Moisturizer
And here are the best acne treatments for more severe acne (many of these will require a prescription!).
One option your dermatologist might prescribe for acne is dapsone gel, such as the brand-name version Aczone. Dapsone is both antimicrobial and anti-inflammatory, and it’s proven to help get rid of blackheads, whiteheads, and deeper painful pimples. Oftentimes dapsone is used alongside other acne treatments. And as with many of those other remedies, this can cause skin to dry out.
Cortisone is a quick fix for acne emergencies, especially large cystic acne bumps. Go to the dermatologist’s office for a shot of this corticosteroid, and the pimple will dramatically lessen and possibly even disappear in 24 to 48 hours. The treatment works to curb inflammation, which makes it best for cystic breakouts and can be really good at combating hormonal acne flare-ups.
However, if done incorrectly, a cortisone shot can leave a small depression in the skin that lasts about eight weeks. “It’s a rare side effect that happens if the dosage of cortisone is too high,” Dr. Linkner explains. “You want to go to someone who knows what they’re doing.” So this method is best saved for those rare emergencies and should not be considered a long-term treatment for your acne.
If you notice that you’re breaking out right around your period every month, your acne might be linked to hormones. When it comes to hormonal acne, “a sensitivity to the hormones called androgens manifests in the form of cystic acne,” say Dr. Linkner. Androgens, namely testosterone, cause the skin to produce more sebum. More sebum equals more acne. Combination hormonal birth control, which contains the hormones estrogen and progestin, helps keep hormones balanced and skin clear. Ortho Tri-Cyclen, Estrostep, and YAZ are all FDA-approved as acne treatments.
Sometimes birth control alone isn’t enough to really make a difference in hormonal acne. That’s when your doctor might recommend adding in an androgen blocker such as spironolactone. Spiro (as it’s often called) minimizes the amount of androgen hormones in circulation by blocking the receptors that bind with testosterone. When these pills are taken at the same time as an oral contraceptive, many women see an improvement in breakouts, according to Dr. Linkner. The drug is sometimes prescribed to women with polycystic ovarian syndrome (PCOS) to relieve androgen-related symptoms like excessive hair growth, hypertension, oily skin, and acne.
Also known by the brand name Tazorac, this is another powerful prescription retinoid, but it’s synthetic. Like other retinoids, it can cause side effects like dryness and irritation, so you should always follow your dermatologist’s instructions for when and how to use it. Interestingly, it can also be used to help manage plaque psoriasis and may be combined with other topical medications, like corticosteroids, to do just that.
Isotretinoin (formerly sold as Accutane) is a particularly strong retinoid. It has a mixed reputation, but among dermatologists it’s the finisher for patients with severe acne. “If you have an acne patient that doesn’t respond to anything, [isotretinoin] can really be a game changer,” board-certified dermatologist Adam Friedman, M.D., tells SELF. Commonly referred to as Accutane even though that particular brand was discontinued, isotretinoin is an oral retinoid, and it has all the benefits of a topical retinol but is even more effective.