Acne
What is acne?
Acne comes in two main forms:
Inflammatory acne – red pimples, pustules, and deep cysts
Comedonal acne – blackheads and whiteheads
Most people have a mix of both, so the best results come from treating both types.
The acne aisle can feel overwhelming, but here’s one key truth: price does not equal results. Expensive products often contain the exact same active ingredients as affordable store brands.
How do I treat acne?
Most people get the best results from a simple two-step plan:
Adapalene gel (Differin, Effaclar, Glenmark, AcneFree, ProActiv) – This used to require a prescription but is now available over-the-counter. It works especially well for blackheads and whiteheads and is the best OTC option to help shrink pores. Apply at bedtime (see below).
Medicated acne wash – I recommend benzoyl peroxide (BP) or azelaic acid over other ingredients. A liquid wash in the shower makes your routine easier (see below).
Most brands make BP cleansers, but expensive doesn’t mean better.
Higher strengths (10%) cause more dryness without extra benefit—stay under 5%.
My top pick: CeraVe Acne Foaming Cream Cleanser (4% BP).
Other good option: AcneFree 2.5% BP wash.
Azelaic acid is safe in pregnancy but and great for teens (often paired with niacinamide).
Salicylic acid works, but head-to-head studies show BP is more effective.
Additional tips:
Camouflage redness – Clinique’s Redness Solutions base or foundation is excellent for reducing the redness of acne while you wait for breakouts to heal. In my experience, it works better than acne cover-up patches.
Manage stress – Acne often worsens with stress. Deadlines at school or work, relationship problems, illness, or a loss can all trigger breakouts. If you know a stressful event is coming, start treating your acne-prone areas early to help prevent flares. This site has simple, helpful ideas for lowering stress.
Eat for clearer skin – Diet can affect acne. Fast food and junk food often make breakouts worse, especially when combined with stress. Switching as many meals as possible to whole-food, plant-based options can help improve acne and reduce flares.
How to Use Adapalene at Bedtime
Start with clean, dry skin.
Dab a pea-sized amount of adapalene gel on the forehead, sides of the face, and chin (outer areas of face).
Rub it in gently.
Use whatever is left on your fingers to lightly spread around the nose, cheeks, and lips (these spots are more sensitive).
💡 Note: This will make your skin dry and flaky at first. That’s normal—it happens to everyone. Your skin will adjust after a few weeks.
🚫 Warning: Don’t use adapalene if you’re pregnant or trying to become pregnant. It may harm a developing baby.
After Adapalene: Moisturize
Right after applying adapalene, use lots of moisturizing cream or ointment. My favorites are CeraVe Cream, Vanicream Cream, or Vaseline (#SlugLife)
Put on a thick layer and go to bed a little shiny—your skin will soak it in overnight.
🕒 Stick with adapalene for at least 30 days—it takes about a month to start seeing results.
Steps for using a medicated acne wash:
In the shower, rinse your face (and chest/back if you have acne there).
Apply the benzoyl peroxide wash and leave it on for 5–10 minutes so the medication can soak in before rinsing.
Use benzoyl peroxide wash once or twice daily. You do not need another face wash. Avoid exfoliating scrubs.
Notes:
Benzoyl peroxide can cause dryness. Apply plenty of moisturizer until your skin adjusts and acne improves (usually after a few weeks).
Benzoyl peroxide can bleach towels and clothing.
My face is peeling from adapalene—What should I do?
Peeling is very common when starting adapalene. Most people think their skin is “too sensitive,” but often the problem is how it's being used—not that it’s the wrong product.
Adapalene dries out your skin before it helps it. The first month is tough—but stick with it! It takes about 30 days for your skin to grow from the bottom up, and that’s when you’ll start seeing real results. It will work! Trust the process!
Tips to reduce peeling and redness from adapalene:
Use the right amount: Only a pea-sized amount is needed for your whole face.
Start on the outside of your face: Apply to the forehead, cheeks, jawline, and chin first. Use what’s left on the nose and near the lips—these areas are more sensitive.
Moisturize a lot: You can’t over-moisturize. Use CeraVe, Vanicream, or Vaseline—especially at night.
Stick with it: Use it every night for one month to see benefits. If nightly use is too much, try every other night—just stay consistent.
Try the “sandwich method”—Put on a thin layer of moisturizer, then adapalene, then a thick layer of moisturizer on top. This helps reduce peeling while still giving you the benefits.
What if my acne isn’t getting better?
Most people improve with the steps above, but sometimes prescription creams or pills are needed, especially if there is scarring. For severe or scarring acne, isotretinoin (Accutane) may be the best option. If over-the-counter treatments aren’t working, see a board-certified dermatologist. If you are in or near Utah, you can see me virtually through Honeydew or visit one of my excellent colleagues at the University of Utah.
DISCLAIMER
The statements expressed and content of this website are not intended to be a substitute for professional medical advice. Readers should seek their own professional counsel for any medical condition or before starting or altering any treatment, exercise, or dietary plan. Please see our full disclaimer here.