Acne is the most common skin condition in the United States and is considered a skin disease. Acne-prone skin often requires a targeted approach, focusing on ingredients that tackle the primary causes of breakouts: excess oil or hyperseborrhea, clogged pores caused by hyperkeratinization, and hyperproliferation of Cutibacterium acnes (formally called P. acnes) bacteria. Acne symptoms can include comodones, blackheads, inflammation, redness, and excess oiliness. Products that target acne are considered drugs and contain active pharmaceutical ingredients (APIs) that are approved by the FDA for the treatment and prevention of acne.
There are also cosmetic ingredients that can address some of the symptoms of acne but are not considered APIs so products containing these cosmetic ingredients, while beneficial to acne-prone skin, cannot be marketed specifically to treat acne.
The following are some key skincare ingredients, both cosmetic and API, known for their effectiveness against acne:
Salicylic Acid: Pore Clearing
As a cosmetic ingredient, salicylic acid is added to products to exfoliate the skin, evening skin texture and tone; however, this beta hydroxy acid is also an API that treats and prevents acne when used at concentrations and formulation parameters outlined in the Acne Final Monograph. In over-the-counter acne products, salicylic acid is used between 0.5-2.0% and works by penetrating the pilosebaceous unit due to its oil soluble nature and dissolving the mix of dead skin and oil that can lead to acne. It has comedolytic, anti-inflammatory, and antimicrobial properties which are all beneficial when treating and preventing acne.
Benzoyl Peroxide: Bacteria Killing
Benzoyl peroxide is only used in OTC products and is not considered a cosmetic ingredient. It is a strong oxidizing agent that targets and kills Cutibacterium acnes bacteria and also functions as a mild keratolytic agent. It is found in products at concentrations between 2.5-10% to address both inflammatory and non-inflammatory acne.
Niacinamide: Sebum Regulation
Niacinamide, or vitamin B3, is a cosmetic ingredient and therefore not listed on the Acne Final Monograph; however, it can be beneficial to acne-prone skin. It is known for reducing proinflammatory cytokines addressing inflammation and redness associated with acne. It also reduces sebum production, a contributing factor to acne development, while reducing the appearance of enlarged pores. It pairs very well with other ingredients and is often used in conjunction with APIs to address acne.
Tea Tree Oil: Natural Antiseptic
Melaleuca alternifolia oil, also known as tea tree oil, is an essential oil and cosmetic ingredient that contains bioactive compounds with antibacterial and anti-inflammatory properties that can help reduce the signs of acne.
Sulfur: Oil Absorption
Sulfur is effective at absorbing excess oil and drying out blemishes. It can be found in both cosmetic and OTC products. In acne products it is used between 3-10%. In addition to absorbing excess oil, it acts as a keratolytic agent and has antimicrobial and anti-inflammatory properties. It is a great alternative API to benzoyl peroxide for those that are sensitive to benzoyl peroxide.
Retinoids: Skin Renewal
Retinoids, including retinol, retinaldehyde, and retinoic acid are vitamin A derivatives that encourage skin cell renewal. They help to unclog pores and can reduce the appearance of acne scars, promoting a more even skin tone over time. While retinol and retinaldehyde are cosmetic ingredients, retinoic acid is available by prescription only in the well known product Tretinoin for the treatment of acne and other skin concerns such as aging. Adapalene, the active in Differin, is a retinoid and API offered in OTC products at 0.1% to address acne. Adapelene can also be found in combination with Benzoyl Peroxide in OTC products for the treatment of acne.
Alpha Hydroxy Acids (AHAs): Exfoliation
AHAs, like glycolic and lactic acids, are used to exfoliate the skin, removing dead skin cells that could clog pores. They also contribute to improved skin texture and reduced appearance of acne scars. Unlike BHA, AHAs don’t reduce sebum production and won’t dry out the skin. AHAs are cosmetic ingredients and not listed in the Final Acne Monograph for the treatment of acne.
Azelaic Acid: Dual Action
Azelaic acid has properties that help combat acne-causing bacteria and reduce inflammation. Azelaic acid can be found in both cosmetic, OTC, and prescription products depending on the use level and formulation parameters. It can normalize keratinization to keep pores clear and is helpful for inflammatory acne due to its ability to reduce inflammation. As a cosmetic ingredient, it evens skin tone, lightens post-acne marks, and contributes to a more even complexion.
To effectively manage and reduce acne, it's best to integrate these ingredients into a skincare regimen that suits your specific needs. Consulting with a dermatologist can provide personalized advice to ensure the best treatment plan.
DISCLAIMER: All skin care articles are intended to help educate on specific ingredients and skin care topics. Our articles are written to be informative and informational. Any reference to a specific patient experience is not a medical suggestion for treatment. Please note that any Prequel products with referenced ingredients are formulated for Cosmetic Use Only and NOT intended as replacements for physician advice and/or pharmaceutical product recommendations.
