Topical treatments for acne

In this article

Erythromycin benzoyl peroxide topical gel
Salycic acid
Glycolic acid
Topical sulphur products
Topical retinoids
Azelaic acid cream
Topical antibiotics
Topical antiseptics
Topical zinc sulphate
Topical isotretinoin
Topical acne prescriptions

Having acne means that you need targeted treatments that help to treat inflamed skin caused by acne breakouts. Topical treatments for acne can be useful as they target the skin and acne causes directly making you feel more in control.

Topical acne treatments work in different ways, and may target sebum production, kill the bacteria that colonises the skin leading to breakouts or act as an exfoliant to clear away dead skin cells that could otherwise clog the pores.

Here’s our roundup of the most common topical acne treatments, how they work and what side effects, if any, you may expect.

Erythromycin benzoyl peroxide topical gel for acne

Benzoyl peroxide is one of the most well-known products for helping acne prone skin and is the main ingredient in Oxy 5 and Oxy 10 products. It helps treat acne by killing the bacteria that are a main cause of acne.

A major first line treatment against acne, it’s an effective treatment for many but can cause itchy, peeling or irritated skin in the first few weeks.

Erythromycin is an antibiotic which also helps to kill the skin bacteria associated with acne. These two ingredients are available together in a topical gel called Benzamycin that you can apply directly to the skin to help treat acne. It can make your skin more sensitive to sunlight, so make sure you use sunscreen.

Salicylic acid for acne

Another common ingredient in over the counter topical acne treatments is salicylic acid. Salicylic acid is an exfoliant, which helps to clear the skin of dead skin cells which can build up, clog the pores and cause acne spots.

It can penetrate through the pores of the skin, forcing dead skin cells that have collected there up and out of the pore. It’s most effective at treating non-inflammatory acne, and acne that is caused by multiple blackheads. Salicylic acid also helps to keep sebum under control, making the skin less oily.

You can find salicylic acid in skin creams, washes and wipes, but professional skin specialists can use a stronger solution to perform a salicylic skin peel to exfoliate the skin even deeper.

Salicylic acid can cause the skin to become dry, flaky or irritated. Using an oil free moisturiser usually helps to bring these side effects under control.

Glycolic acid for acne

Whilst salicylic acid is a beta hydroxy acid, glycolic acid is an alpha hydroxy acid. Both have an exfoliating effect, with salicylic acid working well to exfoliate the skin and reduce the pore blocking dead skin cells during an acne breakout.

Glycolic acid on the other hand, works well after a breakout as it helps to reduce the appearance of dark spots and scarring. It works by peeling away the top uppermost layers of skin and encourage the growth of new skin.

As with salicylic acid, glycolic acid can cause some mild side effects including red, irritated, itchy skin.

Topical sulphur products for acne

Sulphur is one of the oldest, and most traditional treatments for acne, as it was used long before antibiotics and topical retinoid creams were available. It works by reducing the level of oil (called sebum) in the skin, by helping the skin get rid of dead skin cells and by killing the bacteria that can lead to acne.

Best suited to mild to moderate acne, that is characterised either by blackheads or inflamed, red spots, sulphur is available in a range of skincare products. You can find cleansers, masks, lotions and creams in most pharmacies.

Topical sulphur products are also ideal for skin that is too sensitive for benzoyl peroxide or retinoid-based creams and gels.

At first, your skin may become dry, flaky or red, but these mild side effects should disappear as your skin gets used to the sulphur.

Topical retinoids for acne

Retinoid drugs are derived from vitamin A. Topical retinoids to treat acne are available in gels and creams that are designed to be applied directly to the skin, usually in the evening before bed.

The two most common topical retinoids are tretinoin and adapalene. They work by having an exfoliating effect, which helps to remove excess dead skin cells from the surface of the skin. Skin that is acne prone often sheds its dead skin cells more quickly than other skin types. This excess of dead skin can clog the pores and lead to acne spots.

Retinoids can make the skin more sensitive to the sun so care must be taken not to burn by wearing sunscreen. It’s usually advised that you use topical retinoids for around six weeks. They’re best used sparingly.

Topical retinoids can cause side effects, and these include a mild stinging sensation or irritation.

There’s a small risk that topical retinoids can cause birth defects, so they’re not recommended for women who are pregnant or planning to become pregnant.

Azelaic acid cream for acne

Sometimes, using topical retinoid treatments or benzoyl peroxide gels isn’t effective enough for more severe cases of acne. If this is you, then your doctor may suggest you use azelaic acid, which is a topical acne treatment available in a cream or a gel.

Azelaic acid acts as both an exfoliant to remove excess dead skin cells and an antibacterial agent, killing the bacteria that leads to acne.

It’s designed to be used twice a day, but if your skin is particularly sensitive, you may find once a day is better for you. Its particularly effective for acne rosacea as it helps to reduce redness by lowering excess levels of melanin in the skin.

You should see an improvement in your skin within four weeks of using azelaic acid for acne. As it’s an exfoliant, you may notice that your skin becomes more sensitive to the sun, so it’s important to wear sunscreen.

Other side effects include burning, itching, dryness or redness, but these should only be mild.

Topical antibiotics for acne

Antibiotics are useful as a first line treatment for acne. They help to kill the bacteria that can colonise the skin and cause acne spots and breakouts. They can be taken orally as tablets, or they can be applied directly to the skin.

Topical antibiotics are usually in the form of lotions or gels, and need to be applied to the skin once or twice a day. Your doctor will advise you how long to use topical antibiotics for, but it’s usually around six to eight weeks.

Using them for any longer than this could mean that the bacteria causing your acne could develop a resistance to them. This could mean that they’re then able to continue to colonise your skin and make your acne worse.

It’s uncommon to experience severe side effects from topical antibiotics, but you may experience some mild burning, redness, irritation or peeling.

Clindamycin is a common topical antibiotic for acne and is available as a gel, foam wash and solution. As well as the other side effects of topical antibiotics for acne, clindamycin can make the skin more oily. Clindamycin is available as a product called Dalacin, a topical solution to help treat acne.

Dalacin is an effective acne treatment but it contains a small amount of alcohol which can cause the skin to sting, especially if it’s irritated. You should avoid getting Dalacin topical solution near sensitive areas of skin such as inside the nostrils, around your mouth and lips or anywhere near your eyes.

Another type of topical antibiotic for acne is Aczone gel, also known dapsone. Aczone gel contains an antibiotic called sulphonamide. It’s commonly used to treat mild to moderate acne and is particularly effective for treating inflammatory acne that causes large, red acne spots and angry, inflamed skin.

Side effects of dapsone include redness, dryness or flaking of the skin and can make the skin more oily. It can be used in conjunction with benzoyl peroxide creams and gels, but doing so can cause yellow, orange or brown staining of the skin. This staining is temporary, and will wash off, but if you’re leaving the house, it’s a good idea to use these two topical acne treatments separately, i.e. one in the evening and one in the morning.

Many antibiotics are unsuitable for use by pregnant or breastfeeding women, but some are. Speak to your doctor if you discover that you’re pregnant whilst using topical antibiotics for your acne.

Topical antiseptics for acne

If you’ve previously used topical antibiotics to treat your acne successfully, but then subsequent treatments using the same product haven’t been as successful, then the bacteria they’re treating, may have become resistant. This means that the antibiotics no longer work to kill these acne causing bacteria.

In these cases, your doctor may suggest using topical antiseptics to help treat your acne. Topical antiseptics still kill acne causing bacteria, just in a different way. They contain ingredients such as iodine and chlorhexidine and are available in creams, gels and washes.

Topical antiseptics for acne can cause the skin to become red, irritated, dry or flaky, but these side effects should only be mild.

Topical zinc sulphate for acne

Zinc is a mineral that helps to support the health of the skin and topical formulas of zinc sulphate are effective at treating mild acne.

Topical zinc sulphate is often used in conjunction with oral antibiotics for acne. Creams and gels containing zinc sulphate are most effective when treating inflammatory acne caused by a build-up of bacteria colonising the skin.

Topical zinc sulphate is well tolerated by most people and isn’t known to cause any side effects.

Topical isotretinoin for acne

Isotretinoin is a drug used to treat acne, and is available as tablets or as a topical gel called Isotrex that you apply to your skin. It’s an effective treatment but can’t be used by everyone and has some side effects that can be severe. For these reasons, it’s not used as a first line treatment, and is most often used when other treatments have failed.

It works by reducing the amount of sebum that is produced by the skin, killing acne causing bacteria, reducing swelling, irritation and redness and preventing clogged pores.

However, it can also cause dry, red or peeling skin, especially around the lips, itching, irritation and can cause the skin to become more sensitive to sunlight. More seriously, topical Isotretinoin can cause anaphylaxis, a serious allergic reaction that requires immediate medical attention.

Topical Isotretinoin gel for acne causes birth defects and is not recommended for use during pregnancy or breastfeeding. You may need to have regular pregnancy tests whilst using Isotretinoin gel if you’re sexually active, and you should take precautions such as condoms to avoid pregnancy.

Topical acne prescriptions

If your acne is mild then you may be able to use over the counter remedies to manage your skin, such as products containing benzoyl peroxide. However, if you have severe acne, your doctor will be able to give you topical acne treatments on prescription. Topical acne prescription drugs include antibiotic creams and retinoid products.

It’s important to never give up hope. There are lots of topical acne products you can try – what works for one person may not work for another, so it’s a case of finding out what works for you.

The Sönd range of alkalising skincare has been developed with acne prone skin in mind. We developed our range for people just like you, who want to find the best products for their acne. We understand what it feels like to have acne first hand and truly hope that you find our products useful.