The ultimate goal of acne treatment and prevention is three-fold:

1. Unplug pores.
2. Remove bacteria.
3. Reduce inflammation and swelling.

There are few over-the-counter medications (or even prescription medications, for that matter) that do all three. Using a combination of medications is the most effective treatment. Full face, daily treatment is essential to halting acne in its tracks and preventing future outbreaks. Remember that by the time you see the outbreak on the surface of your skin, the problem has been festering at lower levels for two weeks - don't stop treatments as soon as your skin is clear!

Benzoyl Peroxide

Benzoyl peroxide is probably the world's best acne treatment. It attacks the P. acnes bacteria very effectively, and after decades of use there is no indication that the bacteria develops a resistance to it. Other reasons for its effectiveness are its ability to penetrate the oil in the plug, and it may control excess sebum production and lessen skin inflammation. All in all, this is your go-to for over-the-counter treatment of acne.

Benzoyl peroxide comes in strengths of 2.5%, 5% and 10%. Start with the lowest strength (2.5%) and give it two weeks. If it's effective, there's no need to go to a higher strength. This is a case where more is not better - higher strength potentially causes more irritation to the skin. If it is effective for you, it will continue to be effective; the bacteria cannot develop a resistance to it.

Salicylic Acid

Salicylic acid is a beta hydroxy acid derived from willow tree bark. It works as an exfoliator to loosen and soften plugged pores. It is most often sold in pre-soaked pads that can be used directly on the skin.

Resorcinol

Resorcinol is another exfoliator, acting much the same as salicylic acid, to loosen and soften plugged pores. It may also help reduce inflammation and fight the P. acnes bacteria. It is frequently combined with sulfur, which is another keratolytic agent. Sulfur also has an antibacterial effect, inhibiting the growth of bacteria, and may help reduce redness and swelling by decreasing the formation of free fatty acids. Most people who are allergic to sulfa drugs, such as Bactrim and Septra, don't experience any difficulty when topically applying sulfur.

Cosmeceutical agents

These are products that have not been FDA approved for labeling as controlling acne. There can be a variety reasons for the lack of label, but it doesn't necessarily mean they aren't at all effective. They may be less effective, but their effect might be sufficient for mild cases of acne. Their labels generally will indicate that they are "blemish fighting," "pore clearing," or "skin calming." These imply acne treatment without violating FDA guidelines.

Are over-the-counter treatments safe?

Over-the-counter topicals are generally safe. The worst that can happen is irritation or an allergic reaction that will go away when you discontinue use of the product. If you do have a reaction, make a note of the product name and ingredients and then avoid products with similar ingredients.