Over the ten years I've had acne, I've come to realize topical treatments like BP and and SA aren't as effective as mainstream, conventional advice from dermatologists would have you think. They only treat the symptoms but not the causes, and sometimes cause more issues (using the two together can make it last longer, as they have different effects), and you may get too dry and irritated, with your skin unable to recover well and thus exacerbating the problem. Of course, to deal with the condition of acne as a whole, a dietary approach consisting of reducing insulin spiking foods with sugar and other carbs, coupled with eating veggies and fruits high in antioxidants (or green/white tea), right balance of omega 3 oils, some berberine, maintaining good gut health and using probiotics, and reducing stress is probably the best way to go. However, these aren't always realistically the most feasible or appealing options to most. I've tried eating almost nothing but protein and fat for a while, and it helped, but after a few months I couldn't do it anymore, because the world around is too tempting: didn't want to be that guy who always says no to stuff in social situations.
Some even recommend doing an intensive detox regimen, and I did a juice cleanse (which was quite painful, with me having fever, headache, nausea, and chills for half a day, supposedly due to accumulated "toxins" coming out into my bloodstream to be flushed away, but I felt amazing the next day). But again, it's hard to maintain this kind of super healthy lifestyle too long.
However, I have noticed topical antioxidants work pretty well to an extent; some pimples slip through the cracks now and then but overall it is reduced. I find I use benzoyl peroxide and salicylic acid only as needed, and usually sparingly. Tea tree oil too. Anyone else agree? I haven't looked through too many other threads yet, but I get the feeling most people use use the chemical cream approach instead of considering other methods and changes in lifestyle.
I agree with your way of thinking! I believe that using a combination of both is the best way to go - tackle acne from both inside and out. If you only rely on topical creams but change nothing else about your lifestyle, you will be less likely to see success because you would only be treating the issue from the surface. On the other hand, if you only try making dietary/lifestyle changes without using any topical creams you might not see success either because you are missing out on the opportunities that those medications provide.
Unfortunatelymost dermatologists only discuss the symptoms and the medical approach without consideration for lifestyle choices. On top of that, when they do give you topical medications, they don't give you much instruction on skincare otherwise. So a lot of people either apply too much, apply it too frequently or use the medication alongside other products that are way too harsh and run into redness/dryness/irritation without any idea of how to handle it.