Moderate Acne Treatment Options

Unlike mild or severe, moderate acne is that breakout-middle-ground of inflamed blemishes, persistent pimples, and blackheads that stubbornly hangs around despite using over-the-counter acne products.

But don't think that you can't get your skin under control; you can. You might just need a different approach (and a different treatment). And there are plenty of treatment options that are really effective.

Hispanic girl putting on acne cream
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Over-the-Counter Treatments

Because moderate acne breakouts are more stubborn than mild acne, it typically doesn't improve with over-the-counter medications.But there is one exception: benzoyl peroxide.

Benzoyl peroxide is considered a very effective OTC acne treatment, reportedly due to its keratolytic, moderate comedolytic, and antibacterial properties. Prescription benzoyl peroxide treatments are also available and help to reduce blackheads and pore blockages including combining it with clindamycin, but it really shines as an inflamed breakout treatment.

If you're breaking out, you may want to try an OTC benzoyl peroxide product first. Give it 8-12 weeks to work. But if you're not happy with the results after several weeks, it's time to move on to something stronger.

Topical Prescription Medications

It's likely you'll need a prescription medication to get your moderate acne cleared up. With so many good prescription acne treatments available, it doesn't make sense to stick with OTC products for just so-so results. You'll be a lot happier with the results of prescription medication, and your physician will probably start you off with a topical treatment first.

  • Topical Retinoids: Topical retinoids are some of the most commonly used topical acne treatments today. They can be used by both teens and adults. Topical retinoids are also prescribed as anti-aging treatments, so they pull double duty for adults with acne. Topical retinoids work by speeding up cell turnover and unclogging pores, so long-term they work to reduce breakouts. They can also help make pores look smaller.
  • Topical Antibiotics: These are only prescribed for inflammatory breakouts, as they won't do much if anything for non-inflammatory blemishes. Topical antibiotics work by reducing the amount of acne-causing bacteria (bacteria called propioni acnes) found on the skin. To get the best results, topical antibiotics should be prescribed along with another acne medication. There is some worry that bacteria are becoming more resistant to antibiotics, and that they are becoming less effective than they used to be.
  • Combination Medications: Combination medications have two acne-fighting ingredients in one medication. Dermatologists have long prescribed several topical acne medications to be used at once because treating acne this way is much more effective. Combo treatments basically take this idea and make it much more convenient. Just one quick application and you're done.

Most combination medications are a marriage of a topical antibiotic and a topical retinoid or benzoyl peroxide.

Oral Medications

If topical medications aren't giving you the results you want, oral medications can be the next step in your treatment. They might even be the first step, depending on your situation. It doesn't have to be an either/or prospect, anyway. Your dermatologist might prescribe both oral and topical medications. Again, it just depends on your situation and your skin.

  • Oral Antibiotics: Oral antibiotics work like topical antibiotics—they reduce the amount of bacteria that contribute to acne breakouts. Again, bacterial resistance is a growing problem with antibiotic over-use; it is generally not recommended to be on oral antibiotics for long periods of time.
  • Oral Contraceptives (Birth Control Pills): Obviously, these aren't an option for the guys. But certain birth control pills can be an effective treatment for adult women who suffer from those "hormonal" breakouts every month. Teen girls can also get relief from acne by going on birth control pills. So, how do birth control pills help clear up acne? They stabilize hormonal fluctuations. Acne development is closely linked to androgen hormones, and it keeps those hormones under control, often clearing up acne. You'll most likely need a topical acne treatment too when using birth control pills to control acne.
  • Spironolactone: Another hormone regulator is spironolactone. This treatment is only appropriate for adult women with acne. Spironolactone is not specifically an acne treatment, as it's used to treat problems such as high blood pressure and fluid retention. But for many women, it's really effective in keeping the skin clear. To be effective, though, it needs to be used long-term.
  • Isotretinoin: Isotretinoin (the medication is better known as Accutane) isn't the first treatment choice for moderate acne, but it can be an option when other treatments have failed. Unlike the vast majority of acne medications, you don't need to use it indefinitely for the skin to stay clear. After a course or two of isotretinoin, acne is usually completely clear and it rarely returns. The decision to take isotretinoin should be discussed thoroughly with your dermatologist. Not everyone is a candidate for isotretinoin treatment.

Call a Dermatologist

Sometimes you can clear up moderate acne on your own with OTC products. But more than likely you'll need help from a dermatologist to get breakouts under control. Don't hesitate to make an appointment with a dermatologist. Moderate acne can be treated, and your skin can improve.

18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Angela Palmer
Angela Palmer is a licensed esthetician specializing in acne treatment.