The Best Over-the-Counter Treatments for Severe Acne

Nothing is a miracle, but this regimen comes close.
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Nothing is a miracle, but this regimen comes close.
The Wonder Years, often not wonderful. Photo: ABC

The Wonder Years, often not wonderful. Photo: ABC

I don’t remember much about middle school, but I do remember a girl named Hera pointing at my forehead after class and observing she could have played connect the dots with my acne if she had wanted to. Children are very cruel. It’s been about a decade since then, and time heals all wounds… mostly. I don’t even remember Hera’s last name at this point, but unfortunately I still deal with acne regularly – the cystic kind, the ones that act as angry, painful red bumps you kind of just want to squeeze up and get it all over with. 

I usually get them on my chin and at the top of my cheekbones. At one point, I got so resigned to their presence on my face that I began joking my cheekbone cysts were actually small horns signifying that I was Maleficent’s daughter, and I’d smother them with highlighter and take creepy pictures of myself. I’m not uncomfortable with my skin to the point where it makes me cry anymore (it did, often!) and I’ve learned habits and products that make severe acne outbreaks a lot easier to manage. While there is honestly no secret product or final cure for cystic acne, I’ve managed to get my skin under control and change the way that I think about skin so that it’s not something I have to solve, but something to get familiar with and listen to. It didn’t happen overnight, though, and I did ask professionals for help and have used prescription medications. 

The following combination of products cleared my skin up to the point of stopping constant breakouts, and my cystic acne now disappears in days – instead of weeks – when it inevitably flares up. 

Mario Badescu Buffering Lotion, $19, available at Nordstrom 

Photo: Mario Badescu

Photo: Mario Badescu

If I could only use one skincare product, it would likely be this one. I’ve seen drastic results from this no matter what face wash I use beforehand. This is designed for deep, cystic acne and works very quickly, containing herbal extracts that act as anti-inflammatory agents. Since it’s also a thin, clear consistency, I can put it on underneath my makeup and feel confident it’s working 24/7.

Renee Rouleau Anti Cyst Treatment, $41.50, available at ReneeRouleau.com

Photo: Renee Rouleau

Photo: Renee Rouleau

This tiny half ounce bottle packs a punch. I’m a huge fan of cortisone shots for acne, but a visit to the dermatologist takes up time and money I don’t usually have. If you tap this gel, which contains ethyl lactate, onto a newly formed cyst with a q-tip, you’ll manage a much quicker recovery and likely won’t even need to go to the dermatologist. I used this on a cystic zit on my nose and it went away in a matter of days. After trying dozens of drugstore acne treatments to no effect, this has totally won me over.

Dr. Dennis Gross Skincare Clarifying Colloidal Sulfur Mask, $42, available at Sephora

Phogo: Dr. Dennis Gross

Phogo: Dr. Dennis Gross

When I asked Elena Arbodela, head aesthetician at Mario Badescu Skin Care, what ingredients to look for to combat cystic acne, she mentioned sulfur. I immediately went out and picked up this mask. I wouldn’t recommend it as an all-over treatment, because if you use it all over, especially in the winter, your skin is more prone to be super flaky, dry and red afterwards. On problem areas as a spot treatment, though, it definitely works to draw out impurities. My skin looked brighter and healthier after my first use. Using this once a week has helped keep my skin under control.

Mario Badescu Healing and Soothing Mask, $20, available at Ulta

Photo: Mario Badescu

Photo: Mario Badescu

One of my greatest paranoias about my skin is that in the process of getting rid of pimple, I’ll do irreparable damage to the dermis it occupies. As Arbodela explains, you can tell if you’ll have pitting or scars by the coloring. “If your breakouts are leaving you with flat dark or red marks, you’re likely not scarred. These are called post-inflammatory hyperpigmentation, or PIH. Marks caused by PIH tend to fade with time," she says. "Focus on getting breakouts under control, and use products that encourage healing at the same time to speed up the skin renewal process.” For this, you want to combat the redness of irritation by using a healing mask. The combination of sorbitol and balsam of peru, an anti-inflammatory essential oil, keeps the skin hydrated and free of bacteria. (Just be aware that balsam of peru can sometimes cause skin allergies in people. Test a small patch on your arm first.)

Fresh Umbrian Clay Mattifying Mask, $49, available at Sephora

Photo: Fresh

Photo: Fresh

Clay masks are kind of the bomb – I think there’s one for every skin type. For those prone to cystic acne, this is great as a spot treatment or a more intense mask for frequent usage. If you’re having an outbreak, I suggest applying this as a mask to your trouble areas multiple nights a week and following up with a gel moisturizer. Umbrian clay is proven to be great for anti-inflammation and helps tone your face, too. Even if you don’t have cystic acne, this is great for mild to severe cases as well.

Olay Professional Pro-X Deep Wrinkle Treatment, $28.99,  available at Drugstore.com

Photo: Olay

Photo: Olay

Retinoids (and the related vitamin A-derived retinols and retinoic acid) are amazing ingredients for anti-aging and anti-acne products but it’s hard to find  outside of prescription products (such as Retin-A) in the concentrated dosage you want for immediate results. However, there are drugstore and over-the-counter options which do contain it. This deep wrinkle treatment contains retinyl propionate, which is a less irritating form of vitamin A. Heads up – you probably won’t see results for months. Still, if you can’t swing a dermatologist, this is something to consider and look into.