Prescription Over-the-counter

Over-the-counter treatments

Alphabetical listing of OTC ingredients

Whatever medication you decide to use, it is important to properly wash your skin before treating.


Alpha hydroxy acid

What it is:

Glycolic acid and lactic acid are the most common alpha hydroxy acids used in skin care formulations, in creams and gels in 10% or lower strength.

What it does:

Alpha hydroxy acids chemically exfoliate the surface of the skin, improving skin texture and tone by removing dead skin cells on the skin's surface. This signals the skin to increase cell turnover, which can help existing acne lesions heal faster and can help pores from becoming clogged moving forward.1-4 The exfoliation produced by alpha hydroxy acids also helps alleviate dry, flaky skin.

Considerations:

Chemical peels in percentages higher than 10% must be administered professionally.


Mild side effects may include stinging and redness.


Because alpha hydroxy acid removes the surface layers of skin cells, the skin can become more susceptible to sunburn in the days following use.5 Be certain to protect your skin with an effective sunscreen when using alpha hydroxy acid containing products and for a week afterward.

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Benzoyl peroxide

What is is:

The FDA allows benzoyl peroxide to be sold by prescription or over-the-counter, in amounts up to 10%, in cream, gel, and wash form. It is an anti-bacterial agent.6-9

(Learn more from the U.S. National Library of Medicine)

What is does:

Benzoyl peroxide penetrates the skin where it kills P. Acnes (acne bacteria).10 Also, there is a mild drying and peeling effect which is thought to help prevent breakouts.6-9 Benzoyl peroxide also helps lessen inflammation.11-13 2.5% benzoyl peroxide is just as effective as higher concentrations with less side effects.10,14

Considerations:

Some dryness, redness, and itchiness is to be expected, especially in the first few weeks of use.10


About 1-3% of people are allergic to benzoyl peroxide and experience an inflammation of the skin or severe crusting.15


Benzoyl peroxide can bleach hair and fabric.6

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Resorcinol


What it is:

Resorcinol is used to treat acne, but also eczema and psoriasis among other skin conditions. It is sometimes combined with other acne medications, usually sulfur, and rarely stands alone.16

(Learn more from Wikipedia)

What it does:

Resorcinol helps break down hard, rough skin, which means it is good at breaking down existing blackheads and whiteheads.16-17

Considerations:

Because it is already potentially irritating, sometimes causing redness or peeling of the skin, it is good to avoid other irritating soaps and cleansers, astringents or alcohol products, and also other medications.16

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Salicylic acid


What it is:

Salicylic acid is an ingredient used in many over-the-counter acne medications at concentrations up to 2%.18 It is often sold with pads as applicators (such as Stri-dex® pads). It is also used to treat other skin disorders including dandruff, psoriasis, calluses, corns, warts, and more.19-21

(Learn more from the U.S. National Library of Medicine)

What it does:

Acne is formed when skin cells inside hair follicles shed too fast and clump together, plugging up the follicle and causing a pimple. Salicylic acid helps slow down shedding of the cells inside the follicles, which may help prevent clogging. Salicylic acid also helps break down blackheads and whiteheads.20-21

Considerations:

Certain salicylic acid containing products may be irritating when used with other over-the-counter medications.20


Results are moderate at best.


People often report a mild stinging when applying the product.

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Sulfur


What it is:

Sulfur has been used to treat acne for thousands of years for its peeling and drying actions, and is found in various washes, soaps, and creams.22

(Learn more from Wikipedia)

What it does:

Sulfur provides peeling and drying of the skin. Although it is effective at breaking down existing blackheads and whiteheads, it may also promote the development of new ones by increasing cell adhesion.22-23

Considerations:

It smells bad. It may also discolor skin.

Side effects include peeling and redness.

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References
  1. Kempiak S, Uebelhoer N. "Superficial chemical peels and microdermabrasion for acne vulgaris." Seminars in Cutaneous Medicine and Surgery. 2008; 27(3): 212-220.
  2. Aztori L, at. al. "Glycolic acid peels in the treatment of acne." Journal of the European Academy of Dermatology and Venereology. 1999; 12(2): 119-122.
  3. Kessler E, et. al. "Comparison of α- and β-hydroxy acid chemical peels in the treatment of mild to moderately severe facial acne vulgaris." Dermatologic Surgery. 2008; 34(1): 45-50.
  4. Ilknur T, et. al. "Glycolic acid peels versus amino fruit acid peels for acne." Journal of Cosmetic and Laser Therapy. 2010; 12(5): 242-245.
  5. Kurtzweil, Paula. “Alpha hydroxy acids for skin care.” FDA Consumer. 1998.
  6. "Benzoyl Peroxide". MedlinePlus. 2010. American Society of Health-System Pharmacists, Inc. 2011.
  7. Berger, et. al. Andrew's Diseases of the Skin. Philadelphia: W.B. Saunders Company, 2000.
  8. Ives T. "Benzoyl Peroxide." American Pharmacy. 1992; 32(8): 33-8.
  9. Weinberg J. "The Utility of Benzoyl Peroxide in Hydrophase Base (Brevoxyl) in the Treatment of Acne Vulgaris." Journal of Drugs in Dermatology. 2006; 5(4): 344-9.
  10. Sagransky M, Yentzer B, Feldman S. "Benzoyl peroxide: A review of its current use in the treatment of acne vulgaris." Expert Opinion on Pharmacotherapy. 2009; 10(15): 2555-2562.
  11. Dutil M. "Benzoyl peroxide: Enhancing antibiotic efficacy in acne management." Skin Therapy Letter. 15(10): 5-7.
  12. Harper J. "Benzoyl peroxide development, pharmacology, formulation and clinical uses in topical fixed combinations." Journal of Drugs in Dermatology. 2010; 8(9): 482-487.
  13. Tanghetti E, Popp K. "A current review of topical benzoyl peroxide: New prospectives on formulation and utilization." Dermatologic Clinics. 2009; 27(1): 17-24.
  14. Fakhouri T, Yentzer B, Feldman S. "Advancement in benzoyl peroxide-based acne treatment: Methods to increase both efficacy and tolerability." Journal of Drugs in Dermatology. 2009; 8(7): 657-661.
  15. Drobil M, Lindemayr H. "Contact Sensitization to Benzoyl Peroxide." Contact Dermatitis. 1981; 7(3): 137-40.
  16. Bowe W, Shalita A. "Effective over-the-counter acne treatments." Seminars in Cutaneous and Surgery. 2008; 27(3): 170-176.
  17. "Resorcinol Topical." Drugs.com. 2010. Cerner Multum, Inc. 1996-2006.
  18. "Questions and Answers About Acne." National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2010. National Institutes of Health. 2011.
  19. Shalita A. "Comparison of a Salicylic Acid Cleanser and a Benzoyl Peroxide Wash in Treatment of Acne Vulgaris." Clinical Therapeutics. 1989; 11(2): 264-7.
  20. "Salicylic Acid Topical." MedlinePlus. 2010. American Society of Health System Pharmacists, Inc. 2011.
  21. Lionel F. The Encyclopedia of Visual Medicine Series: An Atlas of Dermatology. New York: The Parthenon Publishing Group, 1997. Pg.148-150.
  22. "Sulfur Topical." Drugs.com. 2010. Cerner Multum, Inc. 1996-2000.
  23. "Questions and Answers About Acne." National Institute of Arthritis and Musculoskeletal and Skin Diseases Jan. 2006. National Institutes of Health. 2001.