There are a lot of ways to treat acne. One of the most popular types of treatments is topical cream. The reason is simple, creams are easy to use and easy to acquire. But do these acne creams really work and are they strong enough to cure acne on their own?

Quick Points

For serious acne consult your doctor. Acne creams are not intended for severe forms of acne like acne conglobata, cystic acne and nodular acne.

Mild acne in the case of whiteheads, blackheads and the familiar acne vulgaris do respond to topical treatment.

Skin type is important when selecting acne cream. Oily skin does not mix well with oily cream.

Many different chemicals are used in acne cream; the most common include benzoyl peroxide and salicylic acid. These chemicals combat acne by making skin uninhabitable for bacteria, sloughing dead skin cells, unclogging pores and diminishing oil production.

It’s common for acne creams containing benzoyl peroxide to dry and stiffen skin. This can be ameliorated by using a good moisturizer, using lower concentration creams or using products with soothing ingredients like aloe vera and kigelia extract.

What Type of Acne Do You Have?

It’s a good idea to know what you’re dealing with before you rush out to the (online) store and purchase a new cream. Acne is somewhat of a catch-all term for any type of recurrent skin blemish, in fact there are many subvarieties of acne that require different types of treatment. Some respond well to acne cream and others do not. Some of those types of acne are:

Acne Vulgaris

Whiteheads

Blackheads

Nodular Acne

Cystic Acne

Acne Conglobata

Without getting into too much detail the main distinction between these types of acne is where the infection occurs: on the skin surface of below the skin surface. The types of acne that occur below the surface of the skin are least affected by topical treatment and even the most powerful acne cream will only have a minimal effect. Cystic acne, nodular acne and acne conglobata occur deep under the surface of the skin and often require a multi-prong approach of life style changes, medication and trial and error. Sometimes acne cream can do exactly what it’s supposed to and not improve your skin. For example, if the cream kills all bacteria while irritating and drying the skin your skin may actually get worse. Often the bacterial infection is only a result of a deeper problem such as hormones from puberty, stress, and diet. If you suspect you have cystic acne, nodular acne or acne conglobata consult your doctor or skin specialist. In fact, that’s the first thing you should do if you feel any of the following:

Uncomfortable using home remedies

Suffer from deep below the surface acne

Experience self-esteem issues due to acne

Experience pain or physical discomfort

In any other case it’s fine to experiment with home remedies and over the counter acne cream. Dietary changes to healthier greener and leaner foods are known to work wonders for the skin. Additionally any kind of activity that induces sweating followed by a shower is extremely effective in both improving complexion and unclogging pores. Remember the skin is the largest detoxification organ!

The types of acne that DO respond well to acne cream include acne vulgaris, whiteheads and blackheads. These types of acne occur due to clogged pores and overactive sebum production.

How to Select the Right Acne Cream

The first thing you need to know is what type of skin you have. If you have oily skin then you want to avoid creams that are mostly oil based because they will increase your sebum production. Most creams have at least some oil base to keep them viscous and pliable. (Our Sausage Tree Cream is minimally oily due to the use of aloe vera!)

Typical Active Ingredients in Acne Cream

As we’ve learned acne cream is best used for mild acne or in conjunction with dietary and lifestyle changes. The best acne cream products for mild acne contain benzoyl peroxide, salicylic acid, sulphur, tea tee oil, or a combination of these and other countervailing ingredients used to soothe skin.

Salicylic acid dissolves the oil and dirt on the surface of skin and allows you to rinse away the debris that often clogs pores – one of the primary causes of acne. You may be using salicylic acid already and not even know it, that’s because salicylic acid is the active ingredient in Aspirin! There are two forms of salicylic acid: alpha hydroxyl acid and beta hydroxyl acid. Both forms exfoliate the skin. The main difference is that alpha hydroxyl acid is somewhat stronger and will make you sensitive to the sun. Salicylic acid is used in creams, gels and even pad wipes. For the most part salicylic acid is gentle on the skin and not likely to cause significant irritation.

Benzoyl peroxide is a long lasting chemical ingredient in the vast majority of acne products that fights acne by decreasing the number of P. Acne bacteria that are largely responsible for surface infection. It comes in variety of concentrations from 0.5% to 10% and also in the form of bar soap, lotion, cream and gel. Benzoyl peroxide can take between 4 and 6 weeks to begin to improve your skin, so it requires some patience and diligence. As noted before benzoyl peroxide can dry, stiffen and irritate the skin and so it often necessitates the use of a good moisturizer in tandem to soothe the skin. Alternatively some opt to use a lower concentration, it’s been suggested that 2.5% is optimal for mild acne while not causing much irritation. Nevertheless a good moisturizer is recommended when using benzoyl peroxide.

Sulphur is used to treat acne and other skin conditions. It is most effective in reducing flakiness and itchiness as a result of outbreaks. Sulphur is also a powerful anti-biotic and will kill the bacteria P. Acne that is responsible for most surface infection. Most significant of all sulphur decreases natural sebum production and facilitates the natural exfoliation of dead skill cells. It is generally mild on skin and not known to cause irritation.

Tea tree oil is a natural ingredient found in many acne creams and gels. It is best used at concentrations of 5% and provides many of the same benefits as benzoyl peroxide with additional antiseptic and antifungal properties. It is also less irritating to the skin than benzoyl peroxide and does not cause bleaching. The drawback is that it’s often more expense to produce.

Retinol is a less common chemical ingredient based on vitamin A. It is useful in combating acne anywhere on the body but causes sensitivity to the sun and as such is best used at night time and with sunscreen.

Triclosan is another infrequently used chemical ingredient used to kill P. Acne bacteria due to its ability to be absorbed into skin quickly. It’s often used in conjunction to benzoyl peroxide and salicylic acid and in face and body wash products.

Finally, many of these ingredients can be highly irritating to the skin, causing dryness, redness and stiffness so it’s a good idea to look for acne creams with soothing additives like aloe vera, sage extract, and lavender oil or moisturizing ingredients that combat skin “stiffness” like eucerin, jojoba, and kigelia extract. Many “advanced” over-the-counter products exist with different steps and stages but it’s often a one size fits all approach that doesn’t work for everyone. Whether you’re choosing an acne cream or other more advanced solution always keep in mind the following: your skin type, the instructions and patience.

If you have any comments or feedback please feel free to drop me a line below! 🙂

Oh and because I thought it was cool I’ve attached a flow chart on how medical schools teach their students to diagnose and treat acne: