Not all products found in the skin-care aisle are treated equally under U.S. Food & Drug Administration (FDA) guidelines. Whereas moisturizers and serums are considered cosmetics and don’t require approval before they hit the market, acne treatments fall into the drug category. That means the FDA regulates which active ingredients, and at what concentrations, can be included in the formula. Currently, only three single actives are permitted—sulfur, salicylic acid, and benzoyl peroxide. How do you know which is right for you?
According to Dr. Sonia Badreshia-Bansal, a board-certified dermatologist in Danville, California, all three are effective at treating acne and can be safely combined at lower concentrations—for instance, a sulfur face mask, a salicylic acid cleanser, and a benzoyl peroxide spot cream can all have a place in your regimen. But, she notes, “everyone has different reactions and acne clearance times,” so introducing one targeted treatment at a time can help determine which is most beneficial for your type of acne. Here’s a breakdown of how sulfur, salicylic acid, and benzoyl peroxide work plus the best spot treatments in each category.
Sulfur for acne treatment
“Sulfur is a natural mineral that can help as an antimicrobial,” explains Dr. Badreshia-Bansal. “When used as a topical acne treatment, sulfur decreases the bacteria that causes acne, removes oil from the skin’s surface, and exfoliates dead skin cells, to prevent blackheads.” As the gentlest of the anti-acne actives, it’s great for all skin types—even sensitive and redness-prone complexions—and combines well with benzoyl peroxide, salicylic acid, and retinoids. In treatment products, you’ll find sulfur in concentrations of 3–10%.
Sunday Riley Saturn Sulfur Spot Treatment Mask ($20)
This spot treatment—designed to be left on blemishes for 20 to 30 minutes, then rinsed off—contains 10% sulfur, to take down pimples quickly; 4% niacinamide, to calm inflammation;, and bentonite clay,to absorb oil and unclog pores.
Kate Somerville EradiKate Acne Treatment ($26)
A cult favorite that claims to significantly reduce breakouts in just one hour, this pink potion is formulated with the maximum level of sulfur plus zinc oxide and BHAs in order to help regulate sebum production and clear up congestion. It works especially well at keeping those under-the-skin pimples you can feel forming from getting bigger.
Epionce Purifying Spot Gel Blemish Clearing Tx ($40)
This potent gel combines 3% resorcinol monoacetate with 4% sulfur (FDA regulations allow sulfur in concentrations of between 3% and 8% when formulated with resorcinol monoacetate). One of the more under-the-radar actives, resorcinol monoacetate is a phenol—an antiseptic and disinfectant that can be toxic in high amounts but is considered safe in acne products and certain chemical peels. It’s highly effective at eliminating breakouts, but you should avoid it if you have sensitive, reactive skin and check with your doctor before use if you’re pregnant.
Related: 14 Skin-Care Ingredients for Busting Cystic Acne
Salicylic acid for acne treatment
“Salicylic acid, as a medication, is used most commonly to help exfoliate the outer layer of the skin,” says the derm. “It helps improve clogged pores in order to neutralize bacteria while preventing pores from clogging up again. It also promotes the shedding of the outermost layer of skin cells, allowing room for new cell growth.” It works best on blackheads and whiteheads; cystic acne typically requires stronger treatment. You’ll find salicylic acid in concentrations of 0.5% to 2%.
Perricone MD Acne Relief Maximum Strength Spot Gel ($19)
This clear, non-tacky treatment is formulated with salicylic acid, clarifying tea tree oil, bacteria-killing acids, and soothing citrulline (the most beneficial ingredient in watermelon). “It’s one of the only gels that I can apply multiple times a day without drying my skin out,” says RealSelf deputy editor Alix Tunell.
Hero Cosmetics Micropoint for Blemishes ($13)
The 173 pointy, salicylic acid–infused spears on this pimple patch don’t penetrate the skin but still deliver the ingredient—in targeted, concentrated fashion—right to the center of the zit and keep it there all day, to fight acne and prevent the introduction of new bacteria. This early-stage treatment is intended to be used at the first sign of breakout, to nip the blemish in the bud. “It feels so comfortable and invisible that I forget I have it on,” says RealSelf head of content Carolyn Hsu.
SkinCeuticals Blemish + Age Defense ($92)
Though it’s meant to be an allover face serum for those with acne-prone, oily, or combination skin, RealSelf director of consumer content Mari Malcolm uses this blend of salicylic, glycolic, citric, and dioic acids as a spot treatment “to get rid of any zit within a few days.” At $92, it’s a serious splurge, but fans swear it has stopped recurring breakouts, improved tone, and helped minimize the appearance of acne scars.
Related: The Best Treatments for Acne Scarring, According to Derms
Benzoyl peroxide for acne treatment
“Benzoyl peroxide breaks down in contact with the skin in order to produce nontoxic benzoic acid and oxygen, which is effective at killing acne-causing bacteria, breaking down comedones [blackheads and whiteheads], and inhibiting inflammation,” says Dr. Badreshia-Bansal. The active is “great for papules and pustules,” also known as those painful, liquid-filled pimples. The FDA permits benzoyl peroxide in concentrations of 2.5% to 10%, and providers recommend you ease in with a lower concentration if you’re unsure how your skin will react. It’s also especially important to use sunscreen when treating skin with the ingredient.
Jan Marini Benzoyl Peroxide 10 Percent ($42)
This maximum-strength formula is basic, in the best way. The 10% benzoyl peroxide dries up acne overnight, while the glycerin keeps the skin around the blemish from getting red or flaky. It’s ultra-powerful though, so you might want to save it for bigger breakouts and deep cystic pimples.
Urban Skin Rx Clear Complexion Acne Serum + Spot Treatment ($22)
Benzoyl peroxide can be irritating to some people; if your skin can’t handle 10%, take things down a notch with this 5% BP/5% glycolic acid formula. For particularly congested skin, smooth a thin layer all over the face before applying a gentle, oil-free moisturizer.
La Roche-Posay Effaclar Duo Acne Spot Treatment ($29.99)
RealSelf contributing senior editor Jolene Edgar has used this 5.5% benzoyl peroxide formula for years. “I find it clears pimples overnight, without drying or irritating the skin—and a tube lasts forever because you only need a tiny drop.”
