Acne is not just a teenage problem — it affects 85% of teenagers and a significant proportion of adults, with many women experiencing hormonal acne well into their 40s. Effective OTC treatments exist, but knowing which ingredients actually work is crucial.

What Causes Acne?

Acne develops from four main factors: excess sebum production (often hormonally driven), follicular hyperkeratinisation (skin cells don’t shed properly, blocking pores), colonisation by Cutibacterium acnes bacteria, and inflammatory response. Hormones — particularly androgens — drive sebum production, which is why acne peaks at puberty, and why hormonal acne flares around the menstrual cycle are so common.

OTC Ingredients That Work

Benzoyl peroxide (2.5–5%) — the most evidence-based OTC acne ingredient. It kills C. acnes bacteria, reduces inflammation, and helps unblock pores. Start with lower concentrations (2.5%) to minimise dryness and irritation. Can bleach fabrics — apply carefully. Salicylic acid (0.5–2%) — a BHA (beta-hydroxy acid) that dissolves inside pores, clearing blockages. Particularly effective for blackheads and whiteheads. Adapalene 0.1% — a retinoid available OTC in the UK. Regulates skin cell turnover, prevents follicular plugging. Gold-standard ingredient; requires 8–12 weeks of consistent use before full effect. Can cause initial “purging” (temporary worsening). Niacinamide (5–10%) — regulates sebum, anti-inflammatory, strengthens skin barrier. Excellent for sensitive skin or as an adjunct to other actives. Azelaic acid (10–20%) — antibacterial, anti-inflammatory, helps with post-inflammatory hyperpigmentation.

Building an Acne Skincare Routine

Morning: gentle cleanser → niacinamide serum → lightweight non-comedogenic moisturiser → SPF 30 (essential — many acne treatments increase photosensitivity). Evening: gentle cleanser → active treatment (benzoyl peroxide or adapalene) → moisturiser.

When to See a GP

OTC treatment is suitable for mild to moderate acne. See a GP if: acne is nodular or cystic (risk of scarring), OTC treatment hasn’t worked after 3 months, acne is causing significant psychological distress, or there are signs of hormonal imbalance. Prescription options: topical antibiotics, oral antibiotics, combined oral contraceptive, isotretinoin (Roaccutane).

Shop Acne Treatments at Chemist 2 Customer. Related: Skincare Guide.