The most effective over-the-counter acne treatments are benzoyl peroxide, adapalene (a retinoid) and salicylic acid, used consistently for at least 8 to 12 weeks with a gentle cleanser and non-comedogenic moisturiser. Moderate or severe acne, or acne that leaves scars or dark marks, needs a doctor’s assessment, because prescription treatments work well and prevent long-term damage.
What causes acne?
- Excess oil (sebum) from hormones
- Blocked pores (dead skin cells)
- Bacteria (Cutibacterium acnes)
- Inflammation
Triggers can include hormonal changes, some medicines, heavy cosmetics and hair oils, and possibly high-sugar diets in some people. Acne isn’t caused by poor hygiene.
A simple daily routine
- Cleanse twice daily with a gentle, fragrance-free cleanser
- Treat with one active ingredient (start with one)
- Moisturise with a non-comedogenic moisturiser
- Protect with sunscreen daily, especially when using retinoids
Over-the-counter treatments
| Ingredient | How it works | Tips |
|---|---|---|
| Benzoyl peroxide (2.5–5%) | Kills acne bacteria, reduces inflammation | Can bleach fabrics; start low to reduce irritation |
| Adapalene 0.1% | Unclogs pores, prevents new spots | Use at night; expect dryness at first; avoid in pregnancy |
| Salicylic acid | Exfoliates inside pores | Good for blackheads and whiteheads |
| Azelaic acid | Reduces spots and dark marks | Helpful for darker skin tones; often prescription strength |
Give treatments 8 to 12 weeks before judging results.
When to see a doctor
- Painful nodules or cysts
- Scarring or dark marks
- No improvement after 3 months
- Acne affecting your mood or confidence
- Sudden adult acne with irregular periods or excess hair (possible PCOS)
Prescription options
- Combination creams (e.g. retinoid with benzoyl peroxide or antibiotic)
- Oral antibiotics for a limited time, alongside topical treatment
- Combined contraceptive pill for some women
- Isotretinoin for severe or scarring acne, under specialist supervision; it must not be taken in pregnancy and requires strict pregnancy prevention and mood monitoring
Acne on darker skin
- Spots often leave dark marks (post-inflammatory hyperpigmentation) that last longer than the acne
- Treat acne early, avoid picking and use daily sunscreen
- Avoid bleaching creams and harsh scrubs
- Avoid heavy hair oils and pomades near the forehead
Myths
- Toothpaste on spots: irritates skin
- Scrubbing harder: worsens inflammation
- Sun clears acne: temporary, and worsens dark marks
Frequently asked questions
Does chocolate cause acne?
Evidence is mixed; some people notice diet triggers. Keeping a diary can help.
Related reading: PCOS guide · Eczema guide
Checked against NHS guidance on acne. Updated 5 November 2026.