Did you come to college hoping to leave the battle with acne behind you in high school? I know I did. Fortunately, there are many treatment options for mild acne available at the Student Health Services Pharmacy that do not require a prescription. If you are experiencing more severe breakouts (>10 pimples at once) you should make an appointment with your doctor or dermatologist before treating yourself.
General Skincare Advice:
Make sure you wash your face twice a day with a gentle cleanser, such as Cetaphil. It is also important to take off any makeup before going to bed. Try and avoid touching, picking, or squeezing any pimples as it may cause permanent scarring. There are some studies that suggest dairy and diets high in sugar may cause acne, but no specific dietary changes are currently recommended for acne control.
Over-The-Counter (OTC) Options for Acne:
Benzoyl Peroxide (BP)
How does it work? BP kills bacteria that typically causes acne and helps unclog pores.
What’s out there? BP comes in washes, foams, creams, and gels in a variety of strengths.
What side effects does it cause? You may experience redness and peeling while using BP.
What else should I know before trying it? BP can bleach fabrics or hair, so wash your hands after use and avoid contact with with clothing and furniture. You will also want to make sure that you put on sunscreen while using it because it may make you more sensitive to the sun. BP can be used alone or in combination with a topical retinoid.
How do they work? Retinoids help to keep your pores unclogged.
What’s out there? Several options exist, but only adapalene (Differin) 0.1% gel is currently available without a prescription.
What side effects does it cause? Retinoids can cause dryness, peeling, redness, and irritation. If you experience any of these side effects, cutting back use to once every other day may help.
What else should I know before trying it? You may see an initial increase in acne and redness, but these side effects should get better after a few weeks. Make sure to wear sunscreen while using because retinoids can cause sun sensitivity. Adapalene gel and other retinoids can be used alone or in combination with benzoyl peroxide.
Salicylic Acid (SA)
How does it work? SA helps to remove top layers of skin and unclog pores.
What’s out there? SA comes in washes, cleansers, creams, gels, and lotions in a variety of strengths.
What side effects does it cause? Salicylic acid may cause dryness or peeling.
What else should I know before trying it? Increased contact time on the face may help with how well salicylic acid works (meaning that cleansers and washes may not be as effective as other formulations).
Alpha Hydroxy Acids (AHAs)
How do they work? AHAs work as exfoliating agents for the skin.
What’s out there? Citric, glycolic, and lactic acids are the most commonly seen AHAs.
What side effects does it cause? AHAs may cause irritation or skin sloughing.
What else should I know before trying it? AHAs are also included in many anti-aging skin care regimens.
How does it work? It is still unknown how sulfur helps with treatment of acne.
What’s out there? Several creams and lotions are available. Sulfur is sometimes found in combination with salicylic acid or resorcinol.
What side effects does it cause? Sulfur has the potential to cause some skin scaling, especially on darker skin tones.
What else should I know before trying it? Sulfur products may be more useful for short-term spot treatment. Some older sulfur products have a strong odor that can be bothersome.
Complementary Alternative Medicine (CAM): tea tree oil
How does it work? Tea tree oil kills bacteria that typically causes acne and helps with inflammation.
What’s out there? Tea tree oil comes in creams, gels, sprays, and patches.
What side effects does it cause? A small percentage of people may develop a rash when using tea tree oil.
What else should I know before trying it? Tea tree oil has been shown to work as well as benzoyl peroxide in some studies, but it may take up to 12 weeks to see the full effects. Only use tea tree oil topically because it can be toxic if ingested.
This is just a short list of what skincare options are out there for the treatment of acne. Many products are prescription only, such as oral and topical antibiotics, hormone therapy, azelaic acid, and isotretinoin (Accutane). If your acne is severe enough you may need to see a doctor for one of these medications.
Don’t forget that your doctors and pharmacists at the Student Health Center are here to help if you have any questions or want a recommendation!
Allison Carr, PharmD Candidate 2019
- Adapalene (topical), alpha hydroxy acids, benzoyl peroxide, salicylic acid, sulfur (topical), and tea tree oil. Lexi-Drugs. Lexicomp. Wolters Kluwer. Hudson, OH. Available at https://online.lexi.com. Accessed June 5, 2018.
- Zaenglein MD, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol . 2016;74(5):945-973. doi: 10.1016/j.jaad.2015.12.037.