Spot treatments are designed to give problem pimples a mega-dose of concentrated benzoyl peroxide — in a couple of regimens, like the Proactiv Teen Kit, the spot treatment had nearly three times the benzoyl peroxide as its all-over treatment. The logic: If benzoyl peroxide can be irritating to the skin in high concentrations, limiting its intensity to just the pimple itself could save the rest of your healthy skin.

How to Handle It: Consider salicylic acid your secret weapon. "This beta hydroxy acid helps remove excess oil and exfoliate dead cells from the skin's surface to keep pores clear," says Zeichner. Try Clinique's Acne Solution Clearing Gel, a two-time Best of Beauty winner that packs both salicylic acid and sea whip extract — an ingredient with skin-soothing properties — to help counteract the dryness sometimes caused by salicylic acid. The formula does double duty: It works as a spot treatment for mild to moderate acne and as a nightly allover treatment for pimple prevention. And since it dries clear, you can wear it to fight zits whenever, wherever.

Back acne (sometimes called "bacne") is a potentially embarrassing and sometimes painful condition where clogged hair follicles on the back cause pimples and blackheads. Back acne can be caused by the same factors as other types of acne: diet, hormones, certain medications, genetics or any combination thereof. But when you're considering how to get rid of back acne, also remember that most people have their back covered the majority of the day. The clothing we wear matters, and the way in which we wash the skin on our back is key for clear skin, the whole body over. Learn more about common back acne causes, the best acne products for your body, and how to prevent acne on the back from returning in this section.

Doxycycline is another of the tetracyclines that's equally effective in treating acne. It comes in generic versions and also as the branded Doryx and Acticlate which are easier on the stomach. Originally FDA approved for the treatment of rosacea, Oracea is a non antibiotic dose of doxycycline that is often used as an acne treatment, as well. Taken orally, it can be used as solo therapy or in combination with a topical acne treatment regimen. More severe cases of acne might need higher doses of doxycycline, but since Oracea is not an antibiotic, many patients can be "down-graded" to Oracea after improvement and it's suitable for longterm use as it doesn't cause antibiotic resistance.
But the side effects of targeted breakout cream treatments aren’t always worth it. “So many products instruct consumers to use benzoyl peroxide spot treat red bumps and pustules. I don’t recommend it,” says Dr. Lawrence Green, board-certified dermatologist and assistant clinical professor of dermatology at George Washington University. Such high concentrations of benzoyl peroxide cause added irritation and inflammation to already sensitive skin, so with this in mind, we cut kits that included spot treatments.
A 2013 study on acne vulgaris in The Nurse Practitioner concurred that a multidimensional approach to acne is usually necessary because most people have a combination of symptoms. Based on the advice of dermatologists and aestheticians, we turned our focus to regimen sets, analyzing the ingredients of more than 40 kits before finding our top picks.

And a retinoid, which we’ve touched on before, is beneficial for exfoliating the skin and purging your pores of dirt and oil, which is why Zeichner says they’re helpful for cysts, too. He recommends Differin, the only prescription-strength retinoid that’s available over the counter, and which many derms here have suggested to us before for acne-prone skin. He says you can use a pea-size amount and start applying it every other night as your skin gets adjusted to it (or combine it with benzoyl peroxide and salicylic acid for a stronger mixture).
Oral isotretinoin is very effective. But because of its potential side effects, doctors need to closely monitor anyone they treat with this drug. Potential side effects include ulcerative colitis, an increased risk of depression and suicide, and severe birth defects. In fact, isotretinoin carries such serious risk of side effects that all people receiving isotretinoin must participate in a Food and Drug Administration-approved risk management program.
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