Benzoyl peroxide is generally considered the best spot treatment for acne, but there are others that may be just as effective and less likely to cause side effects like redness or peeling. In the end, the “best” spot treatment is the one that works for you.

This article explains how spot treatments for acne work and covers four medications commonly used in drugstore acne creams, gels, and lotions.

How Acne Spot Treatments Work

OTC spot treatments work by delivering acne-fighting agents directly to a blemish.

They only work for minor, surface-level papules (solid, inflamed bumps) and pustules (pus-filled bumps). They won’t treat severe blemishes like acne nodules or acne cysts, which form deeper within the skin where the spot treatments can’t reach.

Spot treatments can help:

Reduce the redness, swelling, and pain of inflamed pimples Loosen or dissolve blockages within pores that create blemishes in the first place Treat acne in a targeted way, protecting unblemished skin from the side effects of some of these treatments (e. g. , drying and redness)

Some spot treatments are left on overnight; others dry clear so that you can wear them throughout the day. Others still are tinted to help camouflage red, inflamed pimples.

OTC spot treatments are typically dabbed on a pimple once or twice daily. To ensure the best results, always follow the manufacturer’s instructions on the product label.

Benzoyl Peroxide

Benzoyl peroxide is the most effective OTC acne treatment around. It helps treat acne in three ways:

It is sebostatic, meaning that it reduces the production of an oily skin substance called sebum that contributes to pore blockage. It is comedolytic, meaning that it prevents or reduces the formation of comedones like blackheads or whiteheads. It is antimicrobial, able to inhibit the growth of Cutibacterium acnes, the main bacteria associated with acne.

Even so, benzoyl peroxide can cause side effects, particularly in people with sensitive skin. These include:

Skin redness Dryness Burning and irritation Hives

Benzoyl peroxide can also bleach fabrics, so take care when applying the lotion or cream around colored towels, sheets, or clothing.

Salicylic Acid

Salicylic acid is a type of acid that works best on open comedones (blackheads), closed comedones (whiteheads), and mild acne. It functions as an exfoliant, meaning that it helps clear dead skin cells from the surface of the skin that contribute to pore blockage. It can also help dry pimples.

Depending on the formulation and the concentration of salicylic acid (ranging from 0.5% to 3.0%), you may need to apply the spot remedy one to three times daily. As with benzoyl peroxide, it is best to start slowly and increase gradually as tolerated.

Side effects of salicylic acid include:

Skin tingling or stingingItchingRednessPeeling

Acne Stickers

Acne stickers, or “pimple patches” are exactly what they sound like—little stickers that you put over a pimple. The stickers contain hydrocolloid, a moisture-absorbing dressing that can draw acne cysts to the surface and dry them out.

Pimple patches also prevent you from picking at the pimple, keeping it clean and infection-free.

Sulfur

Sulfur is another ingredient that works best on mild acne, blackheads, and whiteheads. It fights acne by creating a hostile environment for Cutibacterium acnes and other bacteria associated with acne.

Its antimicrobial effects, while robust, are not as effective for moderate to severe forms of inflammatory acne.

Although they are gentler, sulfur-based spot treatments can cause side effects like:

Skin drynessIrritation

Differin (Adapalene)

Adapalene is the active ingredient of the brand name acne product called Differin. Differin is the only topical retinoid acne treatment available over the counter.

Like other topical retinoids, adapalene works by causing surface skin cells to turn over and die rapidly, making way for new skin cell growth. By doing so, pores are less likely to become blocked by dead skin cell debris.

Differin comes in a gel formulation and contains 0.3% adapalene. It is approved for use in people over 12 years of age and is applied once daily before bedtime.

Side effects of adapalene tend to be mild and may include:

Skin redness Burning and irritation Drying Itching Photosensitivity (meaning your skin can turn red when exposed to the sun)

Common Acne Spot Treatment Mistakes

Spot treatments can be a helpful addition to your acne treatment routine. But you may be using them incorrectly and not even know it.

Here are three common mistakes that people make when using OTC acne spot treatments:

Overdosing: Using any spot treatment product too often will dry out the skin and can cause irritation, redness, and peeling. Combining treatments: You may think that hitting acne with more than one OTC remedy will improve the results, but all it may do is increase the risk or severity of side effects. Irregular use: Medications like salicylic acid and adapalene take time for their exfoliating effects to work. To get the best results, you need to use OTC spot treatments daily and as directed.

When to See a Healthcare Provider

OTC spot treatments are most useful for occasional, localized outbreaks. If you have frequent, widespread, or severe outbreaks, these products may not only underperform but increase skin redness and irritation.

If OTC treatments aren’t doing enough to keep you acne-free, it may be time to see a skin specialist known as a dermatologist who can prescribe topical and oral treatments to better resolve hard-to-treat acne.

Generally speaking, it is time to see a dermatologist when:

You have been treating acne for 10 weeks with OTC treatments but have not been able to control outbreaks. You have severe acne, including cystic acne or nodular acne. OTC remedies are causing severe irritation, pain, or peeling.

Depending on the type and severity of acne you have, your dermatologist may recommend effective prescription treatments like BenzaClin, Retin-A, or isotretinoin.

Summary

There are numerous over-the-counter (OTC) spot treatments available to help clear or prevent acne. These are applied daily and are best suited to treat blackheads, whiteheads, and mild acne.

OTC spot treatments typically contain one of four active ingredients: benzoyl peroxide, salicylic acid, sulfur, or adapalene. These products work best when used consistently and as prescribed.

Gently wash your face up to twice daily and after sweating. Apply a lightweight, oil-free moisturizer after cleansing. Use make-up sparingly to avoid clogged pores. Drink plenty of water throughout the day. Keep your hands off your face to avoid bacterial contamination.