Clinical vs. OTC Acne Treatments

Acne is a common skin condition in which skin pores become clogged and produce whiteheads, blackheads or pimples. It is usually caused by hormonal changes during puberty, but can occur in later life as well. Acne is most often mild, producing only inflammation and breakouts, but may occasionally be severe enough to produce cysts or even scarring. Acne appears most often on the face, neck, chest or back.

OTC Treatments

Mild or moderate acne may be treated with an over-the-counter acne treatment such as Proactiv, Murad acne complex or products containing alpha hydroxy acid, benzoyl peroxide, or tea tree oil. Acne treatments such as these have the advantage of being relatively affordable and available without a doctor’s prescription. The drawback to over-the-counter acne remedies is that they may not work for people whose acne is more severe.

Clinical Treatments

A clinical acne treatment is one that must be obtained from a doctor. Prescription drugs used to treat acne include oral antibiotics such as Erythromycin and Tetracycline, prescription-strength anti-microbial topical creams, such as Clindamycin or Benzoyl Peroxide, or topical retinoids such as Adapalene. Clinical treatments are stronger and usually more effective than over-the-counter treatments, while their increased cost and potential side effects make them more risky, they are a logical choice for patients with severe acne.

Tea Tree Oil

Tea tree oil comes from the leaves of Melaleuca alternifolia, famous for their antibacterial properties. Those who can’t use benzoyl peroxide may benefit from tea tree oil. Acne responds well to treatment with tea tree oil. Studies find that tea tree oil works more slowly than benzoyl peroxide, but also has fewer side effects. Those with eczema or allergic skin conditions should avoid tea tree oil. Acne sufferers should use a topical preparation and should never swallow tea tree oil.

Benzoyl peroxide

Benzoyl peroxide is one of the most common treatments for mild to moderate acne. Benzoyl peroxide is available as both an over-the-counter and prescription acne treatment and works against the bacteria that aggravate acne. This acne treatment also helps remove dead skin cells to prevent lesions. Benzoyl peroxide use may result in dry skin, especially if overused. Benzoyl peroxide should also be applied carefully, since it may bleach hair and fabric.

Alpha hydroxy acid

An alpha hydroxy acid is an acid found in foods, such as citric acid or lactic acid, among others. These acids are used in creams and other topical preparations to moisturize skin, treat acne and improve the appearance of acne scars. Alpha hydroxy acids work by removing the top layer of skin cells and firming lower layers of skin. Those using acne remedies containing alpha hydroxy acids should also wear sunscreen, since their use increases sun sensitivity in some people.


Proactiv is an over-the-counter acne preparation containing salicylic acid, which helps correct an abnormal shedding of skin cells and helps unblock pores. Proactiv is sold as a three-step system of cleanser, toner and lotion and users are instructed to use it twice a day. While this acne treatment is readily available and some users say their results have been good, the system is more expensive than most other over-the-counter acne remedies.


Adapalene is a topical prescription cream used to treat mild to moderate acne. Adapalene is a retinoid that works by reducing inflammation and swelling. It may take 2 to 12 weeks to produce complete results. Adapalene may make users more sun-sensitive and may produce severe skin irritation if combined with other topical acne treatments. Those with eczema, sunburn, cut or scraped skin should not use this medication, and should be careful not to get it into their eyes.

Tetracycline for Acne

Dermatologists sometimes prescribe tetracycline for acne, particularly if it’s severe. Tetracycline is an oral antibiotic that may be taken over many months to suppress moderate acne, or in high doses for severe acne. Tetracycline reduces inflammatory acne lesions. Pregnant or breastfeeding women should not take tetracycline for acne, as it may cause skeletal defects in children. It should not be taken by children under the age of 8, as if may affect their growth and stain their teeth.

Murad Acne Complex

The Murad acne complex is an over-the-counter three-step acne treatment system. The first step consists of an anti-bacterial cleanser containing salicylic acid. The second step is an exfoliating gel containing retinol and glycolic acid, and the third step is a moisturizing lotion. Murad acne complex is readily available, and while less expensive than clinical treatment, is more expensive than some other over-the-counter acne products.

Those considering an acne treatment should weigh factors such as the severity of their acne, the price of the treatment and issues such as the presence or absence of other conditions, such as eczema, skin allergies, sun sensitivity and the potential side effects of the treatment being used. In most cases, acne clears up on its own once the hormone fluctuations of adolescence subside.