Pimples
What are pimples?
Acne comes in two main forms:
Inflammatory acne – red pimples, pustules, and cysts
Comedonal acne – blackheads and whiteheads
Pimples (and pustules) are clogged pores filled with oil (sebum), dead skin, and sometimes bacteria. This leads to inflammation and redness.
When treating pimples, price doesn’t equal results—many affordable products contain the same active ingredients as expensive ones.
How do I treat pimples?
The most effective way to treat pimples is to use two things together:
A retinoid gel at night
This combination treats existing pimples and helps prevent new ones.
Step 1: Use a retinoid at night (see how-to-use below).
The best over-the-counter retinoid is adapalene gel (Differin, Effaclar, Glenmark, AcneFree, ProActiv). It is stronger and more effective than retinol or retinal.
Step 2: Use a medicated acne wash
A medicated wash makes acne treatment simple and consistent. I recommend benzoyl peroxide and/or azelaic acid.
Very effective for inflamed pimples. Expensive brands are not better.
Stronger is not better — stay under 5%.
10% causes more dryness without extra benefit
Preferred options:
Leave BP wash on the skin for 3–5 minutes once daily in the shower (see below).
Great for teens and sensitive skin
Safe in pregnancy
Helps with pimples, redness, and dark marks
Salicylic acid can help, but studies show benzoyl peroxide works better.
Extra tips that make a big difference for pimples:
Manage stress: Acne worsens during stressful times—deadlines, relationship issues, illness, or loss. If you know stress is coming, start treating acne-prone areas early to help prevent flares. This site has simple, practical ideas for lowering stress.
Eat for clearer skin: Diet matters for acne. Fast food and junk food (ultra-processed foods) often make breakouts worse, especially during stressful times. Eating more whole, minimally processed foods — especially plant-based meals — can improve acne and reduce flares over time.
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.
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.
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 BP 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.
What if my pimples aren’t getting better?
Most people improve with the steps above, but sometimes prescription creams or pills are needed, especially if there is scarring or stubborn spots. Sometimes 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.