How to get rid of acne: a plan for every type of breakout
Why acne happens, which over-the-counter ingredients help each type of breakout, a simple routine, how long it takes, and when to see a dermatologist.
Written by the Glowpedia team · not yet reviewed by our dermatologist
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Acne is not caused by dirt or by not washing enough. It is a common skin condition with several causes working together, and the right plan depends on which kind of spots you have.
Quick answer: For most mild to moderate acne, use one or two proven over-the-counter actives every day: benzoyl peroxide (start at 2.5%), adapalene 0.1% gel (sold without a prescription in the US), or both. Add a gentle cleanser, a light moisturizer and sunscreen. Give it at least 6–8 weeks. Painful lumps, scarring or no change after about 3 months mean it is time to see a dermatologist.
Why does acne happen?
Acne starts inside hair follicles, the tiny openings people call pores. Four things usually work together:
- Extra oil (sebum). Hormones called androgens make oil glands more active, which is why acne often starts at puberty.
- Clogged pores. Dead skin cells stick together and block the opening of the pore.
- Bacteria. A skin bacterium called C. acnes lives on everyone's skin and grows quickly inside a clogged, oily pore.
- Inflammation. The body reacts to the blocked pore, which causes the red, swollen and sometimes painful part.
Many things can make acne worse: hormone changes around periods, pregnancy or menopause; stress; some medicines; heavy skin or hair products; and friction from phones, helmets, masks or tight straps. Conditions such as polycystic ovary syndrome (PCOS) can also play a role.
Does diet matter?
The evidence is mixed. Some studies link cow's milk (including skim milk) and high-glycemic foods, which raise blood sugar quickly, such as white bread and sugary drinks, to more breakouts in some people. Other studies find no clear link. Diet changes may help some people, but they are rarely enough on their own.
Find your type of acne
Knowing what you see helps you pick the right first step. If you are not sure, see breakouts and acne-prone skin for more detail.
| Type | What you see | Best first step |
|---|---|---|
| Comedonal | Blackheads and small skin-colored bumps (whiteheads) | Adapalene or salicylic acid |
| Inflamed | Red bumps (papules) and spots with pus (pustules) | Benzoyl peroxide, often with adapalene |
| Hormonal pattern | Deeper spots on the jaw and chin, flares before periods | Topicals first; a doctor for hormonal options |
| Nodules and cysts | Large, painful lumps under the skin | A dermatologist, early, to help prevent scars |
| Body acne | Spots on the chest, back or shoulders | Benzoyl peroxide wash; see body acne |
The ingredients that work
You do not need many products. You need the right one or two, used every day.
Benzoyl peroxide
Benzoyl peroxide reduces acne bacteria and helps calm inflamed spots. Bacteria do not become resistant to it, which is why doctors pair it with antibiotic treatments. Dermatologists often suggest starting with 2.5%, which tends to irritate less than stronger versions. It comes as a gel, cream or wash. It can bleach towels, pillowcases and clothes, so use white fabrics or be careful.
Adapalene
Adapalene is a retinoid, a vitamin A–related ingredient that keeps pores from clogging and calms inflammation. In the US, the 0.1% gel is approved for sale without a prescription. It is often the backbone of long-term control, because it helps stop new spots from forming. Use a pea-sized amount for the whole face in the evening.
Salicylic acid
Salicylic acid is a beta hydroxy acid (BHA) that dissolves in oil and helps loosen the dead skin inside pores. It is useful for blackheads and whiteheads and is milder than benzoyl peroxide or adapalene. It is often found in cleansers and leave-on products.
Azelaic acid
Azelaic acid helps unclog pores, reduces acne bacteria and calms inflammation. It may also help fade the dark marks that spots leave behind. It is often a good choice for sensitive skin or darker skin tones. Lower strengths are sold in cosmetics; higher strengths are prescription medicines in many countries.
Niacinamide
Niacinamide (vitamin B3) is used in cosmetics to help with the look of oil and redness. It is a helpful extra, not a main acne treatment.
A simple daily routine
Morning
- Gentle, non-foaming or low-foam cleanser (or a benzoyl peroxide wash, left on for a minute or two, then rinsed).
- Benzoyl peroxide gel, thin layer, if you are not using the wash.
- Oil-free, non-comedogenic moisturizer (one tested not to clog pores).
- Sunscreen, every day.
Evening
- Gentle cleanser.
- Adapalene, a pea-sized amount for the whole face, on dry skin.
- Moisturizer.
Starting slowly: use adapalene every other night for the first two weeks, then every night if your skin is comfortable. Mild dryness, flaking or a short flare in the first few weeks is common. If your skin stings or peels a lot, use it less often and add more moisturizer.
Choosing the right moisturizers matters: skin that is dry and irritated is harder to treat, and people stop their acne treatment when it hurts.
What not to mix
- Benzoyl peroxide and some forms of tretinoin at the same time. Benzoyl peroxide can break down some tretinoin products. Many people use benzoyl peroxide in the morning and tretinoin at night. Adapalene is more stable, and combination gels exist. See retinoids + benzoyl peroxide.
- Several strong exfoliants at once, such as acids, scrubs and a retinoid in the same routine. This can damage your skin barrier and make breakouts look worse.
- Benzoyl peroxide and vitamin C serum at the same time. Benzoyl peroxide may oxidize vitamin C. Use them at different times of day.
Mistakes that keep acne going
- Squeezing or picking. This pushes inflammation deeper and can leave marks after breakouts or scars.
- Changing products every week. Nothing gets enough time to work.
- Scrubbing hard. Acne is not dirt. Rough scrubs and harsh cleansers irritate skin.
- Skipping moisturizer because your skin is oily. Dryness leads to irritation, and irritation leads to quitting treatment.
- Heavy oils, butters or hair pomades near the hairline and forehead.
- Putting toothpaste or lemon juice on spots. These irritate the skin and can cause burns or dark marks.
What to do about one big pimple
A single spot before an event is frustrating, but squeezing usually makes it bigger and slower to heal.
- For a whitehead: cover it with a hydrocolloid patch, a small sticker that absorbs fluid and stops you from picking.
- For a red bump: a thin dab of benzoyl peroxide once or twice a day, plus a cool compress for a few minutes, may help it calm down.
- For a deep, painful lump: do not try to pop it. A warm compress can ease the pain. If you get these often, a dermatologist can help, and they can sometimes treat a single painful spot quickly in the clinic.
How long until you see results?
Acne treatments are slow. Expect at least 6–8 weeks before you see fewer breakouts, and around 3 months or more for clear improvement. Once your skin is clearer, keep a lighter routine going. Acne often comes back if you stop completely.
Acne on darker skin
Breakouts in darker skin often leave dark marks (post-inflammatory hyperpigmentation) that can last longer than the spot itself. Gentle treatment, daily sunscreen and avoiding picking are extra important. Azelaic acid and adapalene are often well suited, and harsh scrubs or strong peels can make marks worse.
When to see a dermatologist
- Painful lumps or cysts under the skin.
- Any scarring, or dark marks that keep building up.
- No improvement after about 3 months of daily over-the-counter treatment.
- Sudden acne in adulthood with irregular periods, extra facial or body hair, or thinning scalp hair, which can be signs of PCOS.
- Acne that affects your mood, confidence or daily life.
A dermatologist can prescribe stronger options. These include prescription retinoids such as tretinoin, topical antibiotics (always used with benzoyl peroxide), oral antibiotics for a limited time, hormonal treatments such as certain birth control pills or spironolactone for women, and isotretinoin for severe acne. Your doctor will explain the benefits and side effects of each. Some of these must not be used in pregnancy.
FAQ
Does toothpaste dry out pimples?
It can irritate skin and even cause burns. A hydrocolloid patch or a small dab of benzoyl peroxide is a gentler choice.
Should I stop wearing makeup?
Not usually. Choose products labeled non-comedogenic, and remove makeup every night with a gentle cleanser.
Can I use acne products when pregnant?
Some are not recommended, including oral and topical retinoids. If you are pregnant or breastfeeding, ask your doctor before using any acne treatment.
Why is my acne worse after starting a new treatment?
Some people get a short flare in the first few weeks of a retinoid. If it lasts longer than about 6 weeks, or your skin burns or peels badly, check with a doctor or pharmacist.
Will acne go away on its own?
For many people, acne improves with age, but it can last into adulthood. Treating it early helps prevent scars and dark marks.
Sources
- Acne: Diagnosis and treatment (American Academy of Dermatology)
- How to treat different types of acne (American Academy of Dermatology)
- Can the right diet get rid of acne? (American Academy of Dermatology)
- Acne (NHS)
- Acne (DermNet)
- Chemical stability of adapalene and tretinoin when combined with benzoyl peroxide (PubMed, NIH)