The pimples and blemishes of acne are caused by oil, dead skin cells and bacteria trapped in the pores of the skin. Although it is a common ailment among teenagers, acne can occur at any age. Though many acne products are targeted at teenagers, the most frequently recommended daily preventative treatment -- a 2 percent salicylic acid formula -- works regardless of age. Young skin is more resilient and can often tolerate harsh and drying treatments better than older skin, but experts say the irritating ingredients found in many acne treatments are usually unnecessary; you should use the mildest formula that works for you.
Treatment does vary slightly, however, with the severity of your acne. Most people with mild to moderate acne will notice results if they use an over-the-counter treatment, while those with stubborn or severe blemishes may need prescription-strength medication.
The only proven over-the-counter treatments are benzoyl peroxide and salicylic acid. Benzoyl peroxide serves as a topical disinfectant, effectively killing acne-causing bacteria in the pores. Salicylic acid works as an exfoliant to remove dead skin cells that can clog pores. Unlike other exfoliants, however, salicylic acid can penetrate the pores to exfoliate the pore lining. There's a wealth of research proving both of these treatments to be effective on their own -- and that they're even more effective when used simultaneously. Other over-the-counter treatments include tea tree oil and sulfur, but neither of these has proven to be as effective.
Experts say that if your skin doesn't respond to over-the-counter treatments, you should consult with a dermatologist who can prescribe something stronger. Those with severe acne -- which consists of inflamed cysts and painful nodules that extend into the deeper layers of skin -- should seek professional treatment from the onset. Cystic blemishes are more resistant to treatment and are more likely to result in scarring.
There is no shortage of information on effective acne treatments, but we found the most credible advice from well-known cosmetics expert Paula Begoun. Beautypedia.com, her subscription-based website, contains dozens of reviews of various acne treatment products, as well as useful information on treatment regimens. Her other website, CosmeticsCop.com, also serves as a great resource of information and reviews. Popular beauty magazines such as Allure, InStyle and Health test name-brand acne treatments as part of their annual beauty awards and provide short reviews of the winning products. But testing methodology is unclear, and the reviews amount to merely a line or two of description.
Medical and trade journals, such as Dermatology Times and The Lancet, outline scientific studies that provide valuable insight into which products are most effective. There are several websites that claim to review acne products. But upon deeper investigation, we found that many of them are sponsored by the brands they recommend and that few, if any, other products are reviewed there. ConsumerReports.org provides information on the benefits and harms of various acne treatments, based on the latest available research, but it does not cover this topic in depth.
Acne treatments are sold by virtually every skin-care company. While many products are similar, however, not all are equal. Paula Begoun says "this is the one category of products where needless irritation is not the exception, but rather the unfortunate norm." This is because many over-the-counter acne treatments contain harsh ingredients like alcohol and menthol that might make the skin "tingle" but don't help clear up acne. Neutrogena Oil-Free Acne Stress Control Triple Action Toner (*Est. $7 for 8 oz.), for example, lists alcohol as its second ingredient. According to Begoun, alcohol is needlessly harsh and can actually do more damage by overdrying the skin. Many experts say drying out the skin with harsh products can cause the skin to overcompensate by producing yet more oil, which can cause even more blemishes.
Despite this, consumers seem to prefer these products to their gentler counterparts. Jennifer Goldstein of Cosmo Girl writes: "Companies make tingly washes and grainy scrubs because research shows that people associate certain sensations with cleanliness. In general, those products do cleanse skin but don't clear up pimples, and they may irritate your skin." Paula Begoun points out that many good acne products don't stay on the market long for this reason. She, along with other experts, warns that you don't have to feel something in order for a product to be working. Begoun suggests that careful shopping is a must.