Anti-acne ingredients

What to know

Acne is a multifactorial condition: hyperkeratosis of hair follicle openings, excess sebum, Cutibacterium acnes overgrowth, and inflammation. Effective ingredients must address at least one of these mechanisms.

Retinoids (tretinoin, adapalene, trifarotene) are first-line therapy for comedonal and inflammatory acne. They accelerate epidermal turnover, dissolve microcomedones, and reduce sebum production. Adapalene 0.1% is OTC in most countries and has the best tolerability profile among classical retinoids. Trifarotene (Aklief 0.005%) is a fourth-generation retinoid effective on facial and truncal acne.

Salicylic acid 0.5–2% is a lipophilic beta-hydroxy acid. It penetrates sebaceous glands, dissolves plugs, and has anti-inflammatory action. Its lipophilic derivative LHA (capryloyl salicylic acid) penetrates even deeper and works better on post-acne marks.

Benzoyl peroxide 2.5–10% is an antibacterial agent that does NOT induce antibiotic resistance – a major advantage over clindamycin and erythromycin. The 2.5% concentration matches 10% efficacy with less irritation; this is the consensus in modern guidelines.

Azelaic acid 15–20% is a rare ingredient that works on acne, pigmentation, and is safe in pregnancy. OB-GYNs frequently prescribe it during pregnancy when retinoids are contraindicated.

Niacinamide at 4–5% regulates sebum production and reduces inflammation. It pairs well with retinoids, softening their irritation, and with benzoyl peroxide.

What works poorly: plant extracts without an active compound, activated charcoal in masks («pore detox» is a marketing myth), tea tree oil below 5%, «pore-clearing» clay masks.