The Gentle Approach to Treating Stubborn Breakouts

If it feels like everyone you know is waking up with painful, angry zits right now, you're not mistaken. Dermatologists are getting cries for help from a growing number of acne patients, and it's no wonder. "Because of the pandemic, people who don't usually break out are dealing with flare-ups from chronic stress and disrupted sleep," says Laurel Geraghty, M.D., a dermatologist in Oregon. "Plus, daily mask wearing is making acne a more common complaint."

But here's the good news: There are three new FDA-approved medications for treating moderate to severe acne and a slew of excellent OTC topicals (including adapalene, a retinoid that used to require a prescription). There's also an entirely different game plan for getting clear. Forget drying out your skin and smothering it with products, which typically leads to inflammation and more breakouts. Dermatologists advise a gentler — and more effective — approach. Here's your guide on how to treat acne without breaking out the big guns.

A Less-Is-More Routine

Who hasn't thrown the kitchen sink at a pimple problem in desperation? You try a glycolic acid cleanser, then a salicylic acid spot treatment, followed by a retinoid, only to wind up with irritated skin and possibly more acne. "Overdoing it with products causes a breakdown of the skin's protective barrier," says Shari Marchbein, M.D., a dermatologist in New York. "Once that barrier is compromised, you can get an inflammatory response in the form of more acne. It's a vicious cycle." (

Instead, use fewer active ingredients in a smarter way. "Apply only one acne product in your a.m. and p.m. routine," says Dr. Geraghty. "Cleanse in the morning with a benzoyl peroxide wash to kill acne bacteria [short contact time on the skin minimizes the potential for irritation], or use a gentle cleanser and then a product that helps unclog pores, like one with azelaic or salicylic acid."

Try Paula's Choice 10% Azelaic Acid Booster (Buy It, $36, paulaschoice.com) or Skinceuticals Silymarin CF (Buy It, $166, skinceuticals.com), which includes 0.5 percent salicylic acid and silymarin, "an ingredient derived from the milk thistle plant that helps control sebum production and inhibit blackheads and whiteheads," says Dr. Marchbein.

At bedtime, go for a gentle cleanser followed by adapalene, a proven retinoid for acne. Try Differin Gel 0.1% (Buy It, $12, amazon.com). Apply this every other night, then gradually bump it up to nightly to help avoid inflammation," says Dr. Geraghty. Like other retinoids, adapalene also helps with any dark spots left behind.