Acne is a common inflammatory skin condition that has severe psychological effects on patients, especially when it leads to scarring.
Approximately 80% of young adults and adolescents have the condition, and an increasing number of adults are experiencing adult-onset acne due to lifestyle factors and stress.
Topical treatments are often the first-line of therapy when we notice pimples popping up on our face, and they are a must-have in any acne treatment program.
Coming in washes, solutions, lotions, gels and creams; they are easily accessible and relatively cost-effective – but with so many products on the market, it can be difficult to figure out what is the best.
The trick? To look out for their active ingredients. When it comes to acne treatment, each ingredient often provides one or a few of these properties:
- Antibiotics or antiseptics to reduce bacteria count
- Anti-inflammatory effects to calm red, inflamed skin
- Antioxidants to protect cells from free radicals
- Comedolytics to unclog pores
- Keratolytics to peel off the skin’s surface
They are several studies to support the use of topical products, but it ultimately depends on the combination of ingredients you use, and whether they will work on your specific skin and acne type.
Let us now dive deeper into the top 5 acne-fighting ingredients that are proven to work!
#1: Benzoyl peroxide
Benzoyl peroxide is a tried-and-true ingredient that is synonymous with acne treatment.
It is essentially a topical disinfect that possesses anti-microbial, anti-inflammatory and comedolytic properties.
What this means is that it unclogs your pores, dries our your pimples and kills the P.acnes bacteria to prevent acne from forming. It does this by introducing oxygen into the pore – and since acne-causing bacteria cannot survive in an oxygen-rich environment, the population is reduced which in turn reduces breakouts.
It is an important treatment for those with mild-to-moderate inflammatory acne and is often combined with antibiotics to reduce bacterial resistance and increase the efficacy of treatment.
A recent randomised controlled trial of five antimicrobial regimens for treating mild-to-moderate inflammatory facial acne showed moderate or greater improvement in 60% of patients using benzoyl peroxide and concluded it was the most cost-effective treatment.
Available in concentrations like 2.5%, 5% and 10%, scientific studies have found that a 2.5% concentration has the same effects as 5% and 10% concentrations — so there’s no reason to go higher to minimize side effects.
The most common side effects of this ingredient include dryness, erythema, peeling or stinging during application.
Otherwise, people using benzoyl peroxide will generally notice an improvement by the third week of treatment, and will enjoy having this ingredient as their mainstay emergency spot treatment!
#2: Topical retinoids
Topical retinoids are a form of vitamin A that helps to speed up the skin’s healing abilities and leads to faster shedding of the top layer of dead skin cells to reveal brighter, healthier skin.
They can either be used as a monotherapy to treat inflammatory acne, or in combination with other treatments to control the formation of microcomedones, reducing the formation of lesions and decreasing sebum production. There is also some research to suggest that topical retinoids can help with scarring.
A 2017 review stated that retinoids should be a mainstay treatment for acne since it is shown to be effective in treating different types of acne.
The most common products are adapalene (Differin) and tretinoin (Retin-A), but one that you should consider is Retinol.
In study after study, retinol has been shown to build collagen, improve skin’s texture, tackle fine lines and wrinkles and fight acne. While it is often touted for its anti-ageing benefits, retinol is also recognized for reducing breakouts, shrinking pores and improving oily skin.
The most common side effects of retinoids are skin dryness and increased sun sensitivity, so it is vital that you have adequate sun protection after starting treatment.
It is also important for beginners to introduce retinoids gradually into their skincare routine as it can be too harsh on the skin; which in that case, reducing the strength and frequency of application can help.
Similar to the oral retinoid isotretinoin, which is known to be one of the closest solutions to an “acne cure”, topical retinoids like retinol have been linked to fewer and less adverse side effects; although both should be avoided for patients who are pregnant or trying to conceive.
Also, it generally takes a longer time for retinoids to take effect (up to 6 weeks) but it can be combined with benzoyl peroxide to maximize the treatment.
Acids are valuable in any acne-fighting regime as they work as natural exfoliators that encourage cellular renewal, and can be further divided into alpha-hydroxy acids (e.g. glycolic, lactic, malic and mandelic acid) and beta-hydroxy acids (e.g. salicylic acid)
Alpha-hydroxy acids like glycolic acid are especially great for treating blackheads and getting rid of excess sebum and help to loosen and remove dead skin cells while lightening post-acne scarring and brightening your complexion!
Azelaic acid also falls into this category and boasts anti-inflammatory, antibacterial and antioxidant qualities that make it perfect for calming redness and reducing spots.
In general, alpha-hydroxy acids are much gentler on the skin and well-tolerated on all skin types. They are also ideal for those who cannot tolerate benzoyl peroxide and retinoids and work pretty quickly, so you can expect to see improvements in under a week.
A 2010 study that examined 248 participants with mild-to-moderate acne using azelaic acid found that the effectiveness was high in 64.2% of patients and that it was very tolerable on the skin.
On the other hand, beta-hydroxy acids like salicylic acid are especially effective on very oily skin and when you have blackheads in addition to acne pimples.
It works by naturally exfoliating the skin cells to unstick from one another and prevents it from becoming clogged and prevents future comedones from forming.
One study compared using 0.5% salicylic acid twice daily to a placebo in a 12-week trial, with those using salicylic acid showing a great reduction in acne!
The most common side effects of using topical acids include skin irritation, swelling, itching and redness.
Acids typically range from 0.5% to as high as 20%, and it is important to start by using lower concentrations or consult with your doctor should you wish to utilize acids for treating severe acne.
Otherwise known as nicotinamide, niacinamide is an essential form of vitamin B3 that has long been used to treat and manage other conditions including rosacea, pigmentation and wrinkles.
It is naturally found in many foods include meat, fish, milk, eggs and green vegetables; however, since it is not naturally produced by our body, it is important that we consume it from external sources or topically.
Scientists suggest that niacin is a precursor needed to aid healing and repair, allowing your body to absorb and neutralize more free radicals and boost cellular energy and increase microcirculation.
But niacinamide’s anti-inflammatory properties is what makes it an attractive treatment for acne. It is suggested that a 2% topical niacinamide may also inhibit the production of oil and is relatively non-irritating and gentler as compared to other topical products such as acids and retinoids.
A study in the International Journal of Dermatology showed that a 4% niacinamide gel used twice daily significantly decrease acne in just 8 weeks!
As a multi-tasking ingredient, there are also studies showing that topical niacinamide can increase the production of ceramides to help maintain the skin’s protective barrier and build the skin’s moisture barrier.
The benefits of moisture retention can also benefit acne by regulating the amount of oil the sebaceous glands produce and prevent them from going into overdrive.
Have we also mentioned that niacinamide helps to reduce pore size, smoothen out skin texture and brightens your skin at the same time?
Topical 2% niacinamide was found in one study to lower sebum excretion in Asians, and another study found that application of a 4% nicotinamide gel twice a day has the same comparable efficacy to using a topical antibiotic (1% clindamycin) – removing the risks of bacterial resistance!
And since the skin easily absorbs it, this makes niacinamide a wonder topical treatment that is valuable for a wide variety of skin types and conditions!
Are you ready to say hello to acne-free skin?
Even though topical treatments aren’t likely to be the only treatment needed for those facing more severe, cystic acne – it is still a vital part of any treatment regime and is often recommended for maintenance.
The biggest downside to topical products is that they tend to only target a specific acne-causing factor – which means that the results that you get are often limited. This is also the reason why our doctors recommend a combination treatment approach that works to target ALL acne-causing factors.
At The Clifford Clinic, we are proud to offer the best acne spot treatments that are clinically proven to work, safe and customized to work with your unique skin type and needs.
From facials, laser acne treatments such as the Q-switch and Vbeam to the proprietary Agnes and Gold PTT, our doctors follow a stringent selection criteria for all the products and treatments offered in our clinic. We also provide prescribed medications with an appointment.
We also offer acne scar lasers such as Fraxel Dual and fractional CO2, as well as INFINI RF, Secret RF and subcision.
Supplementing your acne treatment with a good skincare routine that is well-balanced and optimized for your skin type will maximize your results, and we can help you work out something that helps you achieve optimal oil control, without facing excessive dryness of the skin.
Our signature Clifford Balancing Cream product is a moisturizer suitable for acne-prone skin and includes nicotinamide while our Clifford Balancing Facial Wash helps to exfoliate the skin, unclog pores and improve skin clarity, all while helping to remove excess makeup and features salicylic and glycolic acid.
If you have been undergoing treatment for about 6-8 weeks and still see little to no progress – contact us to book an appointment to get a customized acne treatment plan today!