Are Over-the-Counter Acne Medications Good Enough?

By Jonathan S. Weiss, MD

Snellville, Georgia 30078

Physician (MD, DO), Dermatology


Acne is the most common skin disease, afflicting 85% of the American population at some point in their lives.

For some individuals, acne may be persistent or severe enough to cause scarring and warrant prescription therapy. In many circumstances, however, acne is a relatively mild affliction that can be treated with over-the-counter (OTC) medications. The two main ingredients in OTC acne preparations are salicylic acid and benzoyl peroxide.

Salicylic acid is commonly found in acne washes and spot treatments.  Acne lesions form when proteins, called keratin, plug hair follicles in the skin. Salicylic acid works by peeling the top layer of the skin and dissolving the keratin that is plugging the follicles.  It is a relatively weak treatment, but can help in the milder forms of acne. Slight dryness and peeling skin can be side effects of salicylic acid.

Benzoyl peroxide (BP) attacks acne in several ways. The compound unplugs hair follicles, reduces inflammation and kills the skin bacteria that cause pimples to become inflamed. BP can be found in OTC products as a wash or gel formulation. Some prescription medications, such as Duac® and Epiduo®, contain benzoyl peroxide in combination with other anti-acne medications. Washes that contain BP are especially useful in treating acne on the back and trunk. Gels are best used as “leave-on” therapy for facial acne. Be careful when using benzoyl peroxide products, as they can bleach colored fabrics. Other potential side effects include skin irritation and allergy, with peeling, redness and itching.

OTC treatments come as single products, or grouped together in kits that provide a step-wise treatment regimen. There is no ideal product or kit for every patient, rather the best products are the ones that suit each individual’s preferences.

Should acne worsen or be severe enough to cause scarring, one should seek the care of a dermatologist.