Benzoyl peroxide
Benzoyl peroxide is a common topical treatment. It has three actions - it kills germs (bacteria), reduces inflammation and helps to unblock pores. Therefore, it often works well to clear inflamed spots and it helps to clear blackheads and whiteheads (comedones). You can buy benzoyl peroxide at pharmacies, without a prescription. It comes in different brand names and strengths - there is a 2.5%, 4%, 5% and 10% strength. Commonly causes mild skin irritation. If your skin does become irritated then stop using it until the irritation goes. Then try again with a lower strength, or reduce the time it is left on your skin before washing off.
Retinoids
Retinoids are good at unclogging blocked pores. They include adapalene, tretinoin and isotretinoin which come in various brand names. They also have some effect on reducing inflammation. Therefore, one is often used early on in acne to help to unblock pores and to treat blackheads, whiteheads and mildly inflamed spots. You need a prescription for all retinoid preparations. Your skin may be more sensitive to sunlight. Therefore, it is best to apply at night and wash off in the morning. A sun protection cream may also help if you are out in the sun.The most common side-effects are burning, irritation and dryness. Therefore, you may be advised at first to use a low-strength, less frequent application and for a shorter duration.
Azelaic acid
Azelaic acid is an alternative that mainly works by unplugging blocked pores. So, like retinoids, it is good at clearing blackheads and whiteheads. It has some effect on reducing inflamed acne too but probably not as much as antibiotics or benzoyl peroxide. However, it may cause less skin irritation than benzoyl peroxide.
Combinations
Some preparations contain a mixture of ingredients. For example, benzoyl peroxide plus an antibiotic, or a retinoid plus an antibiotic. These may work better than either ingredient alone.
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