Topical Acne Treatments (2023)

This sheet is about exposure to topical acne treatment in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.

What are topical acne treatments?

Topical acne treatments are medications that are put directly on the skin in the form of a lotion, gel, cream, or ointment. There are many different topical acne treatments with different generic and brand names. Topical acne treatments can be over-the-counter or prescription. Common active ingredients in topical acne medications have been benzoyl peroxide, azelaic acid, glycolic acid, or salicylic acid. Prescription topical acne medications might include tretinoin, adapalene, dapsone, or antibiotics such as erythromycin or clindamycin. Products will vary in how strong the active ingredient is and how much of the medication is in the product. Prescription treatments usually have higher amounts of the active ingredients than over-the-counter products.

Are topical medications absorbed through the skin?

In general, the skin serves as a good barrier, so only a small amount of the acne medication is likely to be absorbed with topical exposure. The amount of the medication that can reach the developing baby by absorption through the skin is much lower than with medications taken by mouth. However, more of the active ingredients can be absorbed into the person’s blood stream if the skin is broken or irritated and when it is used over a large area of the skin. The more times the medication is applied on the skin, the more of it can be absorbed.

Are there topical acne medications that may be used during pregnancy?

The American College of Obstetricians and Gynecologists (ACOG) has recommendations, and you can discuss them with your healthcare providers. In general, they have suggested topical benzoyl peroxide, azelaic acid, topical salicylic acid, or glycolic acid for treatment of acne in pregnancy.

I use a topical acne treatment. Can it make it harder for me to get pregnant?

While not well studied, use of topical acne treatments is not expected to make it harder to get pregnant.

Does using topical acne treatments increase the chance for miscarriage?

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Miscarriage can occur in any pregnancy. Based on the data available, the use of topical acne medications is not expected to increase the chance for miscarriage since only a small amount of the acne medication is expected to be absorbed with topical exposure.

Does using topical acne treatment increase the chance of birth defects?

Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. While not well studied, over-the-counter and prescription topical acne treatments have not been associated with an increased chance for birth defects. In many cases, only a small amount of the acne medication is likely to be absorbed with topical exposure, which means little medication gets into the blood stream so little could reach the developing baby. Because only small amounts applied on the skin are absorbed into the body, it is not likely to increase the change for birth defects or cause problems for the baby.

Salicylic acid is related to aspirin. When a person who is pregnant takes an adult dose (325 mg or higher) of aspirin (acetylsalicylic acid) by mouth, there may be risks to the pregnancy. Low dose aspirin (less than 81 mg/day) has been well studied in pregnancy and does not increase the chance of birth defects or other pregnancy complications. When applied on the skin, the amount of salicylic acid that enters the body would be much less than when a woman takes low dose aspirin. For this reason, it is unlikely that topical salicylic acid would pose any risk to a developing baby.

Are there any topical acne medications that should be avoided during pregnancy?

It has generally been recommended to avoid the use of topical retinoid medications, such as tretinoin (Retin A®) and adapalene. Retinoids, when taken by mouth, are known to cause birth defects. Studies have shown that only small amounts of tretinoin and adapalene are absorbed through the skin and that those who use topical tretinoin during pregnancy did not have an increased chance for birth defects. However, due to the theoretical concerns and the availability of other topical acne products, topical retinoid use is discouraged during pregnancy. Please refer to the MotherToBaby fact sheet on Tretinoin at and

Can I use topical antibacterial or antibiotic medications during pregnancy?

When used on the skin, only a small amount of erythromycin and clindamycin antibiotics are absorbed into the blood stream. This small amount is not thought to increase the chance for birth defects or other pregnancy problems. Studies have shown that only a small amount of antibacterial medication dapsone is absorbed through the skin. Studies looking at topical dapsone in pregnancy include only a very small number of exposed pregnancies; and better studied acne products might be preferred for use in a pregnancy.

What if my topical product contains a different active ingredient other than those discussed above?

There are many topical acne treatments available over-the-counter or by prescription, and some of them may contain other active ingredients that are not discussed in this fact sheet. If you have any questions about the active ingredients in your topical acne treatment, please contact MotherToBaby.

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Does using topical acne medication during pregnancy cause other pregnancy complications?

When used as directed, topical acne medications are not likely to increase the chance for pregnancy complications, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces (2500 grams) at birth)

Does using topical acne medications in pregnancy cause long-term problems in behavior or learning for the baby?

Studies have not been done to see if using topical acne medications can cause behavior or learning issues for the child.

Breastfeeding while using topical acne treatments?

Use of topical acne treatments have not been well studied in people who are breastfeeding. However, since most topical treatments are poorly absorbed by the skin, little, if any, of the medication is expected to pass into the breast milk. Make sure that the medication is not placed on the breast area or in any area that may come in contact with your baby’s skin before the medication has dried. Be sure to wash your hands well after applying the medication. Talk to your healthcare provider about all your breastfeeding questions.

If a male uses topical acne treatments, could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects?

Studies have not been done to see if use of topical acne medication could affect male fertility or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at

Selected References:

  • AndersenFA.1998, Final report on the safety assessment of glycolic acid, ammonium, calcium, potassium, and sodium glycolates, methyl, ethyl, propyl, and butyl glycolates, and lactic acid, ammonium, calcium, potassium, sodium, and TEA-lactates, methyl, ethyl, isopropyl, and butyl lactates, and lauryl, myristyl, and cetyl lactates.Int J Toxicol.17(Suppl 1):1–241.


  • AkhavanA & BershadS.2003. Topical acne drugs: review of clinical properties, systemic exposure, and safety.Am J Clin Dermatol4(7): 473-492. [PubMed: 12814337]

  • American College of Obstetricians and Gynecologists (ACOG), Skin Conditions During Pregnancy, 2020, https://www​​/patient-resources/faqs​/pregnancy/skin-conditions-during-pregnancy

  • ChienAL, et al2016. Treatment of Acne in Pregnancy.JABFM29(2):254-262. [PubMed: 26957383]

  • CLASP CollaborativeGroup.1995. Low dose aspirin in pregnancy and early childhood development: follow up of the Collaborative Low Dose Aspirin Study in Pregnancy.Br J Obstet Gynaecol102:861-868. [PubMed: 8534620]

  • CollierEK, et al2021. Pregnancy and breastfeeding in hidradenitis suppurativa: A review of medication safety.Dermatologic Therapy.34(1):e14674. [PubMed: 33320387]

  • FiumeMZ.1998. Final report on the safety assessment of glycolic acid, ammonium, calcium, potassium, and sodium glycolates, methyl, ethyl, propyl, and butyl glycolates, and lactic acid, ammonium, calcium, potassium, sodium, and tea-lactates, and lauryl, myristyl, and cetyl lactates.Int J Toxicol17(Suppl):1-241.

  • al1996. Efficacy and safety of topical azelaic acid (20 percent cream): An overview of results from European clinical trials and experimental reports.Cutis.57:20–35. [PubMed: 8654128]

  • KongYL and TeyHL2013. Treatment of Acne Vulgaris during pregnancy and lactation.Drugs73(8):779-787. [PubMed: 23657872]

  • LoureiroKD, et al2005. Minor malformations characteristic of the retinoic acid embryopathy and other birth outcomes in children of women exposed to topical tretinoin during early pregnancy.Am J Med Genet136(2):117. [PubMed: 15940677]

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  • McCormackWM, et al1987. Effect on birth weight of erythromycin treatment of pregnant women.Obstet Gynecol.69(2): 202–207, [PubMed: 3543767]

  • MeredithFM and OrmerodAD.2013. The management of acne vulgaris in pregnancy.Am J Clin Dermatol.14(5):351-358. [PubMed: 23996075]

  • MuraseJE,et al2014. Safety of dermatologic medications in pregnancy and lactation: Part I. Pregnancy.J Am Acad Dermatol.70(3):401.e1-14. [PubMed: 24528911]

  • NachtS, et al1981. Benzoyl peroxide percutaneous penetration and metabolic disposition.J Am Acad Dermatol4:31-37. [PubMed: 7204686]

  • al2012. Pregnancy outcome following exposure to topical retinoids: A multicenter prospective study.J Clin Pharmacol52(12):1844–1851 [PubMed: 22174426]

  • SongS, et al2003. Combined repeated dose and reproductive/developmental toxicities of benzoyl peroxide.J Toxicol Public Health19(2):123-131.

  • ShapiroL, et al1997Safety of first-trimester exposure to topical tretinoin: prospective cohort study.Lancet.350(9085):1143-1144. [PubMed: 9343507]

  • TylerKH, and ZirwasMJ.2013. Pregnancy and dermatologic therapy.JAAD68(4):663-671. [PubMed: 23182064]

  • YeungD, et al1983. Benzoyl peroxide: percutaneous penetration and metabolic disposition. II. Effect of concentration.J Am Acad Dermatol9(6):920-924. [PubMed: 6643790]

  • WilliamsAL, et al2020. Teratogen update: topical use and third‐generation retinoids.Birth Defects Research112(15):1105-1114. [PubMed: 32643315]


  • WilmerE, et al2016. Drug Safety: Pregnancy rating classifications and controversies.Clinics in Dermatology34(3):401-409. [PubMed: 27265079]

  • UgwumaduA, et al2003. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised controlled trial.Lancet.361(9362):983–988. [PubMed: 12660054]

OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.


Do topical acne treatments work? ›

Topical retinoids and antibiotic creams are most effective when used on blackheads, whiteheads, pustules, and papules. Topical medications may not be as effective for persistent cysts and nodules.

Why doesn t my acne respond to all the treatment I ve had? ›

You May Need a Different Acne Treatment

Not all acne treatments will work for everyone. If you have given your skin at least 10 to 12 weeks and still haven't seen any change, you may need to try a different medication. It's not uncommon to try several medications before finding the one that works.

How long do topical acne treatments take to work? ›

Treating acne with topical products that are available without a prescription takes time and patience. It may take 2 to 3 months of daily use before you see results. And acne may worsen before it gets better.

What is the strongest topical prescription for acne? ›

Tretinoin (brand name Retin-A; see Important Safety Information) is a topical retinoid treatment approved by the FDA for acne vulgaris (Yoham, 2022). Isotretinoin, formerly sold under the brand name Accutane, is a powerful oral retinoid used to treat moderate to severe acne, especially when other treatments fail.

What is the #1 best acne treatment? ›

While it is advised to consult with your doctor about dietary guidance and curating the proper beauty regimen, our experts share that salicylic acid, benzoyl peroxide, sulfur, and topical retinoids like adapalene are the most effective ingredients to treat and prevent acne.

Do acne products actually help? ›

Acne medications work by reducing oil production and swelling or by treating bacterial infection. With most prescription acne drugs, you may not see results for four to eight weeks. It can take many months or years for your acne to clear up completely.

Why isn't my acne going away no matter what I do? ›

If pimples are deep and long lasting, it may be a good idea to see a dermatologist. The dermatologist may prescribe antibiotics to reduce inflammation and kill bacteria that could be causing pimples. In some cases, they might prescribe birth control pills to adjust hormone levels.

Why won't my acne go away no matter what? ›

There are a few reasons a pimple might not be going away. It's normal for some types of acne—especially deep, large pimples—to take some time to clear up. You might also have persistent pimples if you're not taking care of your skin, taking certain medications, or have certain health conditions.

Why am I getting acne even after treatment? ›

Various things can cause breakouts. Stress, certain skin care or acne treatments, dehydration, diet, lack of sleep, contact with the skin, and smoking are all common causes.

How fast can a dermatologist get rid of acne? ›

If a treatment works for you, you should notice some improvement in 4 to 6 weeks. It can take two to three months or longer to see clearing. If you notice improvement, keep using the treatment. Even when you see clearing, you'll want to keep using the acne treatment.

How long do dermatologists take to treat acne? ›

Most of them take a month or two to work. In most cases, the doctor will start by prescribing a topical medication. Possibilities include antibiotics, retinoids, and salicylic acid. If the patient has moderate to severe acne, the doctor may prescribe an oral medication.

How long does it take to treat hormonal acne? ›

How soon after treatment will hormonal acne go away? Treating acne can be different for each individual, but patience is key. Generally, it could take up to four to six weeks to see improvement in your skin after you begin treatment.

What number is severe acne? ›

Grade I (mild) acne showing comedones with few inflammatory papules and pustules. Figure 4: Grade IV (severe) acne showing many large inflamed nodules and pustules as well as scarring.

Is Accutane the strongest acne medication? ›

How Effective Is It? Accutane is the single most effective drug for treating severe acne that hasn't responded to other treatments. About 50% of people who take it experience cleared skin to the point that they never need to treat acne again. Most people take this drug for four to six months.

What dries out pimples the fastest? ›

Apply benzoyl peroxide

The best way to make a zit go away fast is to apply a dab of benzoyl peroxide, which you can buy at a drug store in cream, gel or patch form, says dermatologist Shilpi Khetarpal, MD. It works by killing bacteria that clog pores and cause inflammation.

How do I know if my acne is bacterial or hormonal? ›

One way to tell if acne is hormonal or bacterial is to pay attention to your skin. If you do not experience a flare up during periods of hormonal imbalance, and topical treatments are not improving your breakouts, you may instead be dealing with bacterial acne.

What kills acne bacteria fast? ›

"Benzoyl peroxide helps kill acne-causing bacteria and unclog the pore. Differin makes a topical retinoid and benzoyl peroxide wash that is a great place to start for an anti-acne routine," Campbell says. Another topical chemical that can help is retinoid or vitamin A.

How can I permanently treat acne? ›

Isotretinoin: This is a potent medicine that attacks all four causes of acne—bacteria, clogged pores, excess oil, and inflammation (redness and swelling). About 85% of patients see permanent clearing after one course of isotretinoin.

What age is acne the worst? ›

Adolescents and young adults between ages 12 and 24 tend to be the most affected group. It usually begins during the start of puberty, affecting girls earlier than boys. Typically people will outgrow acne but about 12 percent of women and 3 percent of men may still have acne even in their 40s.

What does stress acne look like? ›

Stress acne tends to look more akin to zits that develop during adolescence, appearing on the more naturally oily areas of the face (forehead, nose, chin). It typically appears as a combination of blackheads, whiteheads, red bumps, and pustules, and rarely appears as a single pimple.

Will I eventually stop getting acne? ›

Many teens find that their acne improves as they get older and that it almost disappears by the time they reach their twenties. Others have acne well into their adult years. The good news is that acne can be treated — and breakouts can sometimes be prevented. Prevention involves taking good care of the skin.

What happens to the pus in a pimple if you don't pop it? ›

Basically, what happens if you don't pop a whitehead is that it goes away on its own, usually in 3 to 7 days. It may happen that you wake up one morning and notice the pimple is gone. Or you may notice the pimple draining.

Why am I still struggling with acne? ›

In response to stress, our bodies produce more androgens (a type of hormone). These hormones stimulate the oil glands and hair follicles in the skin, which can lead to acne. This explains why acne can be an ongoing problem when we find ourselves under constant stress.

What does hormonal acne look like? ›

What does hormonal acne look like? Whiteheads, blackheads, papules, pustules, cysts and nodules are all common hormonal acne symptoms. Normally, whiteheads and blackheads do not cause pain, inflammation or swelling, but if they do, then they are most likely forming into cysts and pustules.

At what age does acne normally go away? ›

Acne commonly starts during puberty between the ages of 10 and 13 and tends to be worse in people with oily skin. Teenage acne usually lasts for five to 10 years, normally going away during the early 20s.

Why does my pimple keep refilling with pus and blood? ›

You can cause a blood-filled pimple by damaging blood vessels around an existing pimple. This often happens when you pop, squeeze, pick or over-exfoliate a pimple. Blood-filled pimples usually heal on their own if you prevent further damage and keep the area clean.

Why is my acne so much worse than everyone else? ›

Genes influence everything from eye and hair color to hormone production, so naturally some people have a propensity for producing higher levels of hormones than others. Therefore, some people are simply more susceptible to acne due to heredity. If your parents were prone to acne, the chances are that you will be also.

How often should you see a dermatologist for acne? ›

You should visit your dermatologist at least once a year for a skin examination. If you have issues between your yearly visit, such as a rash, suspicious growths or acne you should see your dermatologist immediately.

Does drinking water help acne? ›

While drinking a few glasses of water can be part of a hydrating routine and help to remove toxins, it can't cure your acne. That's because acne can be caused by a host of factors, including genetics, which water intake alone can't solve.

How much does it cost to see a dermatologist for acne? ›

On average, an initial consultation with a dermatologist will cost somewhere around $150. Factors such as the location of the practice will also affect the price of dermatology visits as well. Some dermatologists do offer structured payment plans or other payment options, which help make their fees more affordable.

Is it worth it to go to a dermatologist? ›

Not only can a dermatologist diagnose skin cancer, but they can also help identify skin problems that you may think are harmless. Here are a few conditions that may be cause to call your dermatologist instead of self-diagnosing on Google: You spot a mole that is changing shape or size.

Do dermatologists drain pimples? ›

To remove a large pimple or painful acne cyst or nodule, your dermatologist may also use a procedure called incision and drainage. It involves using a sterile needle or surgical blade to open the blemish and then removing what's inside.

Does hormonal acne ever clear up? ›

Hormonal acne often lasts for several years with symptoms coming and going, particularly among younger people. However it can last for short periods of time, such as days or weeks too. Hormonal acne normally improves as you get older. It disappears for most people by their mid 20s.

Why is it so hard to get rid of hormonal acne? ›

Unless your hormonal acne is mild, over-the-counter (OTC) products usually aren't successful. This is because hormonal acne typically takes the form of cystic bumps. These bumps form deep under the skin, out of reach of most topical medications.

Can you get rid of acne if it's hormonal? ›

For acne that's only mild, or is caused by a temporary change in hormones, you should be able to manage with pharmacy treatments. Gels or creams containing benzoyl peroxide can be helpful as this is an antiseptic and an anti-inflammatory. For more severe acne, it's always worth speaking to your GP.

Is acne 100 percent curable? ›

Acne Can't Be 'Cured' But It Can Be Treated Successfully. Some people maintain that acne can be cured through dietary changes. In fact, this idea has become very popular lately.

Which country has worst acne? ›

The prevalence of acne was greatest in countries with a high sociodemographic index (SDI), particularly Western Europe, East Asia, and high-income areas of the Asia Pacific. The regions with the lowest prevalence rates were Central Europe, Tropical Latin America, and Central Asia.

Can you be 30 with acne? ›

Adult acne, or post-adolescent acne, is acne that occurs after age 25. For the most part, the same factors that cause acne in adolescents are at play in adult acne. The four factors that directly contribute to acne are: excess oil production, pores becoming clogged by "sticky" skin cells, bacteria, and inflammation.

Why is Accutane A last resort? ›

Accutane® has been considered the “last resort” when all other drugs or treatments have been ineffective for nodular acne or cystic acne. Its primary indication has always been for treating severe acne.

Are there better options than Accutane? ›

Topical retinoid medications indicated for the treatment of acne include Retin-A (tretinoin), Tazorac (tazarotene), and Differin (adapalene).

Is going to a dermatologist worth it for acne? ›

Moderate or severe acne should always be seen by a dermatologist. It's more likely to cause scarring than the milder forms, and over-the-counter medications aren't strong enough to affect it. Severe acne that suddenly develops in an older adult may actually be a symptom of a disease and should thus always be examined.

Do topicals work for hormonal acne? ›

Hormonal acne does not always respond fully to treatment with acne creams, such as topical retinoids, and antibiotics. In some cases hormonal acne does not even respond well to treatment with Isotretinoin (Isotretinoin/Accutane).

Is oral or topical medication better for acne? ›

While topical treatments can help inflammatory acne, topicals alone are typically not enough to significantly improve inflammatory acne. Oral treatments are extremely good at fighting off bacteria and significantly reducing inflammation, thereby minimizing breakouts and reducing the likelihood of scarring.

Do topical treatments work for cystic acne? ›

A dermatologist can offer suggestions to prevent cystic acne. This doctor can also treat painful acne cysts, lowering the chances of scarring. Antibiotics and topical (skin) creams are effective cystic acne treatments.

Does acne get worse if untreated? ›

Without treatment, acne can also worsen. If acne becomes severe, as it did for Jill, scars can appear as the acne clears. Early treatment can prevent these problems. It can clear the skin and prevent acne from worsening.

How long does it take for acne to clear up after seeing a dermatologist? ›

If a treatment works for you, you should notice some improvement in 4 to 6 weeks. It can take two to three months or longer to see clearing.

How do I know if my acne is hormonal or bacterial? ›

One way to tell if acne is hormonal or bacterial is to pay attention to your skin. If you do not experience a flare up during periods of hormonal imbalance, and topical treatments are not improving your breakouts, you may instead be dealing with bacterial acne.

Does hormonal acne ever go away? ›

Hormonal acne often lasts for several years with symptoms coming and going, particularly among younger people. However it can last for short periods of time, such as days or weeks too. Hormonal acne normally improves as you get older. It disappears for most people by their mid 20s.

What cleared your hormonal acne? ›

Prescription treatments include topical retinoids, tablet antibiotics, or you might be prescribed isotretinoin by a dermatologist. If you're a woman, you might benefit from taking the combined contraceptive pill or a hormonal treatment called co-cyprindiol.

Does zinc help with acne? ›

Zinc is a mineral that can also help with acne. You can take it as an oral supplement or as a topical treatment. A recent review of the past studies on the topic found that zinc can decrease oil production in the skin, and can protect against bacterial infection and inflammation.

What are the alternatives to Accutane for cystic acne? ›

Topical retinoids

Other ones include tretinoin (Retin-A), tazarotene (Tazorac), adapalene (Differin), and trifarotene (Aklief). However, unlike isotretinoin, which you take as a pill, you apply topical retinoids topical, which means they're directly to your skin.

Can you pop cystic acne if it has a head? ›

What not to do. While a cystic pimple heals, it is important to be gentle with the skin. Do not try to pop, pick, or squeeze a cystic pimple. It may be tempting, but popping a pimple can introduce more bacteria to the pore, slow healing, drive the infection deeper into the skin, and increase the chance of scarring.

How do you pop a cystic pimple with no head? ›

Soak a clean washcloth in water that is hot, but not too hot to touch. Apply the warm compress. Hold the warm compress on the blind pimple for 10 to 15 minutes. Repeat the application three to four times a day until the blind pimple comes to a head and releases the pus.


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