What Are The Best Acne Creams?

Jeff Hautala
By Jeff Hautala, Co-Founder of Exposed Skincare

Acne treatments come in all shapes and sizes, but topical acne creams are among the most popular because they often have a great impact with the fewest side effects. But let’s start with the facts about acne for some background first.

From retinol to antibiotics, there are countless acne creams out there.

How Does Acne Form?

Acne is an inflammatory condition influenced by two important factors: bacteria and excess oil production. The pores of inflamed skin constrict slightly, trapping any excess oil, dead skin cells, and bacteria already in the pores.

When acne-causing bacteria (Propionibacterium acnes or P. acnes) 🦠 get trapped in a pore, a pimple forms. P. acnes consume the oil the skin produces and when their numbers grow, an infection may ensue.

How to Find the Best Acne Cream

Many creams fight the P. acnes bacteria, but the active ingredients are sometimes so harsh that they cause inflammation 🔥. Since inflammation is the root of all acne, these types of creams are counterproductive as acne treatments.

Finding the right face cream for you can be tricky, but there are several good options out there—just make sure you know to look out for the bad ones too.

Popular products often contain natural ingredients and chemicals such as bactericidal benzoyl peroxide and exfoliating salicylic acid, but these might not help against serious acne. To fight breakouts, pick products or treatments that suit your pocket and that don’t dry out your skin.

Retinoids for Acne

Retinoids for acne have become the industry’s gold standard for acne treatment, and for good reason. Products containing mild versions or small amounts of retinoids can treat moderate acne, but stronger versions and larger amounts of retinoids can treat 💪 very stubborn and painful acne, like cysts.

What Are Retinoids?

Retinoids are a very concentrated derivative of vitamin A. They are very powerful and not right for everyone.

Retinoids are used on the skin for a variety of reasons, from anti-aging to treating acne, but they function the same way regardless. The stronger type can only be obtained with a doctor’s prescription 👩‍⚕️.

How Do They Work?

Unlike benzoyl peroxide, retinoids are not bactericidal but they regulate cell production and cell death. Retinoids ensure that this happens at a balanced rate so that the skin’s pores don’t clog and cause acne. Researchers also note that

(Retinoids) have broad anti‐acne activity without the risk of inducing bacterial resistance, which justifies their use as first‐line treatment in most types of noninflammatory and inflammatory acne and makes them uniquely suitable as long‐term medication to maintain remission after cessation of initial combination therapy.

What Are The Different Retinoid Products?

There’s a wide variety of retinoid products, from over-the-counter options to prescriptions you can get from a dermatologist. Retinoic acid is an active form of vitamin A that starts regulating skin cells the moment it touches your skin. Retinol, on the other hand, is an inactive form of vitamin A that first needs to be broken down by your skin before it can work.

Retinol for Acne

Retinol first needs to be broken down into retinoic acid to work. This process takes time, and much of the retinol decays before it can be transformed into retinoic acid. This has two results, one good 👍 and one bad 👎.

The Safer, But Perhaps Less Effective Choice

The upside is that the process of cell regulation is gentle, which is ideal for sensitive skin. However, the downside is obvious: retinol delivers less retinoic acid to the skin, so it regulates fewer skin cells and therefore makes less of an impact on acne. If you have sensitive skin and mild to moderate acne, retinol-based acne creams are worth considering, but not if you have moderate to severe acne.

Retinoic Acid – Stronger But Harsher Products

Retinoic acid starts working immediately upon application 👍. This makes it much stronger and more effective than retinol, but it also has more side effects. It can irritate or dry out an already inflamed skin, so this may not be the best option for some.

Better For Cysts

Cysts form when the immune system starts attacking skin cells rather than the P. acnes bacteria 🦠, which then spread deeper into the skin. This allows for a healthy layer of skin to grow over the infection, making it more difficult for bactericidal ingredients such as benzoyl peroxide to reach the bacteria beneath.

When retinoic acid is one of the active ingredients in a topical acne product, it works by encouraging a quick rate of skin cell turnover. This may restore a healthy immune response in the skin.

Retin-A is just one popular brand of tretinoin acne cream, which is most effective against moderate to severe inflammatory acne, like cysts.

Exploring Off-Label Acne Creams

There are also plenty of “off-label” products to look out for. These are products that are not yet officially FDA-approved to treat acne, but their use has been effective.

Why Neosporin for Acne Sounds Like a Great Idea But Really Isn’t

Neosporin is a good treatment for minor cuts and wounds, but it may not be ideal as a topical acne treatment.

Neosporin’s three main ingredients are antibiotics: bacitracin, neomycin, and polymyxin, but it doesn’t contain benzoyl peroxide. Because bacterial infection plays a major role in acne, especially pimples and cysts, it makes sense that Neosporin for acne might be a good idea. Unfortunately, none of those three antibiotics is active against P. acnes bacteria 🦠 specifically. Therefore, this aspect of the Neosporin formula is more or less useless for acne.

However, the petroleum jelly in this product may be effective. Because it’s so thick, it might make sense to believe that it clogs pores, but petroleum jelly actually has a comedogenicity rating of zero. (Comedogenicity is rated on a scale from zero to five, with zero being the least likely to clog pores and five being the most likely.) The jelly forms a protective coating on the skin to prevent bacteria and irritants from getting to it, but it doesn’t clog the pores.

However, this product is not oil-free – it also contains cocoa butter and olive oil. Olive oil has a comedogenicity rating of two, and cocoa butter is a four, so Neosporin is likely to clog your pores.

Mupirocin for Acne

Mupirocin ointment for acne could theoretically help because it’s an antibiotic with an uncommon mode of action -it interferes with bacterial protein formation and is highly effective even against stubborn kinds of bacteria 🦠, like MRSA. Some research has demonstrated its efficacy against acne as equal to standard treatment and other antibiotics, but more study is needed.

Avoid Triamcinolone Acetonide Ointment for Acne

Triamcinolone acetonide ointment for acne might come in handy, but it should not be used regularly. This is because it’s a corticosteroid, which can have negative side effects if used consistently.

Corticosteroids suppress the immune system slightly, so inflammation can subside, which is why some people use them for acne. Unfortunately, corticosteroids aren’t safe for long-term use. When applied for more than three or four weeks, triamcinolone acetonide ointment can cause stinging, irritation, and extra hair growth. Therefore, it is best applied only to large, painful cysts, and then only for a few days to reduce the swelling enough for antibacterial acne creams to work more effectively.

Niacinamide for Acne: Reliable and Effective

Niacinamide could be particularly effective in preventing blackheads and whiteheads.

According to a review of the data, topical niacinamide in the form of a commercial 4% gel (Papulex®) has been shown to provide potent anti-inflammatory activity in the treatment of acne vulgaris. In fact, we love this for your skin in general 👍.

What Is Niacinamide?

Niacinamide is a particular type of vitamin B3. When applied directly to the skin, it addresses two of the main causes of acne: inflammation 🔥 and oil production. Oil-free is not necessarily good, but this vitamin B will not leave your skin dry.

Niacinamide could be particularly effective in preventing blackheads and whiteheads, but it can also diminish inflammatory acne-like pimples and pre-pimples, called papules. It has an excellent side-effect profile and we wish more products contained niacinamide .

The Best Acne Cream Is Part Of A Skin Care System

The best acne cream is one used in conjunction with other products, like the acne creams we make at Exposed Skin Care 🏆. Our Acne Treatment Cream and Clear Pore Serum are both great options for acne treatment, but they work even better when combined with our Facial Cleanser and Clearing Tonic, available together in the Basic Kit. All of our products incorporate both natural and chemical ingredients, like benzoyl peroxide and sage extract, or salicylic acid and green tea extract. Together, this blend of ingredients gently treats acne, preventing any irritation or inflammation that might lead to more acne.

Acne creams are most effective when used with a full skin care system, like the Exposed Skin Care Basic Kit.