Topical acne medications are the first line of defense and the foundation of acne treatment, whether you have comedones (clogged pores), small bumps or inflamed acne. Today, however, there are so many topical acne products on the market that many patients are confused: Which medication is right for my type of acne? How does each one work? And why does my skin sometimes sting, turn red or peel more after applying it?
Getting good, safe results from acne treatment requires a proper understanding of how each medication works. Some topical treatments focus on killing bacteria, while others focus on exfoliating the skin and dissolving blockages. Choosing the wrong type or using the wrong amount may not only fail to clear your acne but can also irritate the skin and trigger even worse breakouts.
In this article, ProDerma Clinic has put together the 5 main groups of topical acne medications commonly used by dermatologists, with an in-depth look at their benefits, how they work, and key precautions you should know before you start, to help you care for your skin and treat acne as precisely and safely as possible.
5 Popular Topical Acne Treatments: How Are They Different and How Should You Choose?
Topical medications are one of the basic approaches to treating acne, but “topical acne medication” does not refer to a single drug. Each group works differently: some reduce acne-related bacteria, some help reduce clogged pores, and some products combine more than one active ingredient to treat both comedonal and inflammatory acne.
Common examples include Benzac, which contains benzoyl peroxide; Differin, which contains adapalene; Epiduo, which combines adapalene and benzoyl peroxide; and Aklief, which contains trifarotene, a topical retinoid. Robaz contains metronidazole, which is often used for certain skin conditions with red bumps or inflammation, especially rosacea. So not every red bump on the face is acne, and they should not all be treated with the same medication.
Although many topical acne medications are beneficial, the choice of medication, frequency and order of application should be based on the type and severity of acne, skin condition, affected area, and any other medications or products being used. Using several irritating medications at the same time without a proper plan may cause dryness, redness, stinging, peeling or a weakened skin barrier, making it impossible to continue treatment.
Therefore, anyone with chronic acne, many inflamed lesions, nodular acne, acne that is starting to leave scars, or acne that does not improve with topical treatment should be assessed by a dermatologist to identify the type of acne and plan appropriate treatment.
Each topical acne medication has a different mechanism and different precautions, especially retinoids such as adapalene and trifarotene, as well as products containing benzoyl peroxide, which may cause dryness, redness, stinging or peeling at the start. Applying a large amount or using several products at once will not clear acne faster, but it may increase irritation to the point where treatment has to be stopped.
- Do not use Benzac together with Epiduo on your own, because Epiduo already contains benzoyl peroxide.
- Do not use Differin, Epiduo and Aklief at the same time, as they all contain a topical retinoid.
- Start with a low frequency, apply a thin layer, and add a moisturizer as advised by your doctor.
- Use sunscreen regularly, as the skin may become more sensitive to sunlight and more prone to post-inflammatory hyperpigmentation.
- If you are pregnant, planning a pregnancy or breastfeeding, tell your doctor before using any acne medication, especially retinoids.
- If you develop swelling, severe stinging, blisters or severe irritation, stop using the product and see a doctor.
Comparison Table of 5 Topical Acne Medications
This table provides basic information to help you understand the differences between these medications. It does not replace a diagnosis or personalized advice from a doctor.
| Topic | Benzac | Robaz | Epiduo | Aklief | Differin |
|---|---|---|---|---|---|
| Key active ingredient | Benzoyl peroxide | Metronidazole | Adapalene + benzoyl peroxide | Trifarotene | Adapalene |
| Drug class | Antimicrobial against acne-related bacteria; helps reduce clogged pores | Antimicrobial with anti-inflammatory action for certain conditions | Combination product with 2 mechanisms | Topical retinoid | Topical retinoid |
| Key benefits | Reduces bacteria associated with inflammatory acne and reduces clogged pores | Reduces red bumps and inflammation in certain skin conditions, especially rosacea | Treats both comedonal and inflammatory acne in a single product | Can be used for acne on the face, chest and back as indicated | Reduces clogged pores and helps prevent new breakouts |
| Best suited for | Inflammatory acne and some types of comedonal acne | Red bumps or inflammatory rashes that a doctor has diagnosed as suitable; not a first-line treatment for all general acne | People who have both comedonal and inflammatory acne | Comedonal and inflammatory acne on the face or body | Comedones, recurring breakouts, and mild to moderate inflammatory acne |
| Usual time of use | Depends on the product form and your doctor's advice | As prescribed by a doctor; may be used 1–2 times daily | Usually once daily, as advised by a doctor | Usually once daily, as advised by a doctor | Usually once daily, often in the evening or at bedtime |
| Main precautions | May cause dryness, stinging, redness and peeling, and may bleach hair or some fabrics | Should be used according to diagnosis; do not use it as a substitute for standard acne treatment on your own | Contains both adapalene and benzoyl peroxide, so do not combine it with products from the same groups without consulting a doctor | May cause dryness, redness, stinging and peeling; should be avoided during pregnancy | May cause dryness, redness, stinging and peeling; should be avoided during pregnancy |
| Do not combine with | Do not layer with Epiduo on your own without a doctor's plan | Must be chosen according to the diagnosed condition | Do not combine with Benzac, Differin or Aklief on your own | Do not use together with Differin or Epiduo on your own | Do not use together with Epiduo or Aklief on your own |
Actual use may vary depending on the strength, formulation, skin condition and your doctor's treatment plan. Do not adjust the frequency, increase the amount or mix several medications on your own. Results and irritation vary from person to person.
The acne medications we see most often, and that work well for acne, are mainly these 5: Benzac, Robaz, Epiduo, Differin and Aklief.
(Click here to book an appointment with a doctor or call 088-0410888)
1. Benzac – Clears Inflammatory Acne
Benzoyl peroxide is a topical acne treatment that kills the bacteria that cause inflammatory acne. It also helps treat comedones by loosening and clearing clogged pores.
When it comes to acne medications, Benzac is probably the one most people know best. It is available in several strengths, but the most popular is 2.5%.
What Is Benzac?
Benzac is the brand name of a topical acne medication containing benzoyl peroxide (BP), which kills bacteria and reduces clogged pores. It is suitable for treating inflamed acne and acne with pus-filled heads.
Size: Benzac 2.5% usually comes in a 60 g tube (price: 409 THB)
What Does Benzac Help With?
- Reduces acne inflammation
- Reduces excess oil on the face, thanks to Acrylates Copolymer, which helps control sebum production
Who Is Benzac Suitable For?
- Oily skin
- Comedones, inflamed acne and pustules
Precautions When Using Benzac
In Thailand, Benzac is available in 2.5% and 5% strengths, and their effectiveness is almost the same. A higher percentage does not always mean better or stronger acne treatment, but it does cause more skin irritation. People with dry or sensitive skin should choose 2.5% to prevent irritation and consult a dermatologist before use.
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How to Use Benzac
Apply before washing your face, twice a day (morning and evening). Leave Benzac on for 5–30 minutes, depending on how long you have been using it, your skin condition and the strength of the product. Avoid the areas around the eyes, lips and the creases of the nose.
- For first-time Benzac users: Use the 2.5% strength. Apply Benzac to inflamed spots and leave it on for 5–10 minutes before washing off. If there is no stinging, dryness, peeling or irritation, you can gradually increase the contact time.
- For regular Benzac users: Leave Benzac on for 15–30 minutes before washing off.
Benefits of Benzac
- Antibacterial: works against Propionibacterium acnes (P. acnes), the bacteria that cause acne, helping inflamed spots dry out, crust and flake off.
- Contains Acrylates Copolymer (AC), a copolymer that releases glycerin to help keep the skin hydrated while absorbing excess oil, a cause of both inflammatory and comedonal acne.
Precautions When Using Benzac
- Avoid the areas around the eyes, mouth, creases of the nose and other thin-skinned areas to prevent irritation.
- Some users may experience stinging, dryness and tightness, redness or peeling when they first start. If this happens, wash it off, shorten the contact time and use more moisturizer.
- If you develop an itchy rash, a burning sensation or severe peeling, stop the medication and see a dermatologist immediately.
(Click here to book an appointment with a doctor or call 088-0410888)
2. Robaz – A Gentler Option for Reducing Inflammation
Robaz is actually topical metronidazole.
An antibacterial acne treatment that can also treat other conditions with acne-like bumps
What Is Metronidazole (Robaz) Gel?
Metronidazole (Robaz) Gel 0.75% contains metronidazole, which inhibits bacterial growth and reduces inflamed acne and pustules. It can also relieve some symptoms of other skin conditions, such as redness caused by dilated blood vessels (rosacea). Using medication to treat skin conditions should be done under the advice of a dermatologist (click here to book an appointment with a doctor or call 088-0410888)
Size: 30 g (regular price 566 THB)
How to Use
Dab onto acne spots twice a day, morning and evening. There is no need to wash it off (unless you experience irritation, stinging or redness, in which case you can wash it off).
- Wash your face thoroughly.
- Dab the medication onto acne spots twice a day (morning and evening); there is no need to wash it off.
- If you experience irritation, stinging or significant redness, you can wash it off.
Precautions When Using Metronidazole (Robaz)
- Avoid the areas around the eyes, mouth, creases of the nose and other thin-skinned areas to prevent irritation.
- Some users may experience stinging, dryness and tightness, redness or peeling when they first start. If this happens, wash it off and use more moisturizer.
- If you develop an itchy rash, a burning sensation or severe peeling, stop the medication and see a dermatologist immediately.
What Makes It Good?
- Helps reduce skin inflammation
- Suitable for red, irritated acne
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3. Epiduo – A Duo That Reduces Both Clogged Pores and Inflammation
Epiduo combines adapalene and benzoyl peroxide in a single tube
What Is Epiduo? (usual size: 15 g)
♦ The main ingredients of Epiduo are adapalene 0.1% and benzoyl peroxide 2.5%, so it treats acne like Benzac and Differin combined.
♦ It effectively reduces acne inflammation, kills P. acnes (the bacteria behind inflammatory acne), and exfoliates the skin so that acne dries out and flakes off more quickly.
♦ Adapalene is a vitamin A acid derivative that works similarly to vitamin A acid, which is widely used to treat acne, but it is much gentler. It helps reduce clogged pores and comedones, reduces inflammation, and also reduces oil production in the pores, making the skin less oily.
♦ Epiduo is suitable for people who have both inflammatory acne and comedones at the same time.
Size: 15 g (regular price 783 THB)
(Click here to book an appointment with a doctor or call 088-0410888)
How to use Epiduo:
♦ Apply evenly over areas with comedones and inflamed acne.
♦ Apply at bedtime; it can be left on without washing off.
♦ If it stings a lot when left on, which may happen because your skin is not yet used to the medication, leave it on for about 15 minutes and then wash it off. Do this for about 1 week to let your skin adjust, then try leaving it on overnight again. The stinging should go away.
Advantages of Epiduo by Galderma
- Available in a 15 g size
- Gel texture that absorbs easily
- The new version comes in a pump bottle for convenience and to reduce contamination after opening
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4. Aklief – A New-Generation Retinoid for Face and Body
Aklief is a new retinoid (trifarotene) that causes less irritation than earlier generations
Aklief is an acne cream with a new active ingredient called trifarotene, which belongs to the retinoid group. It is used to treat comedones and inflammatory acne, including acne on the face, chest and back, and is suitable for people looking for a modern, effective treatment.
Size: 30 g (regular price 1,800 THB)
(Click here to book an appointment with a doctor or call 088-0410888)
Benefits
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Reduces comedones and inflammatory acne
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Exfoliates the skin and reduces clogged pores
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Reduces acne inflammation so breakouts subside faster
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Leaves skin smoother and brighter with continued use
The key active ingredient in Aklief is:
-
Trifarotene 0.005%: a new-generation retinoid that acts specifically on the skin, with less irritation than older retinoids
How to Use
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Wash your face and pat it dry.
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Apply a thin layer only to areas with acne, once a day at bedtime.
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Use an appropriate amount; do not apply too thickly.
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Wear sunscreen during the day, as the skin may become more sensitive to sunlight.
Precautions
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Use under the guidance of a doctor or pharmacist.
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Side effects such as dryness, redness, stinging or flaking may occur at first.
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Avoid use during pregnancy, and consult a doctor if you are breastfeeding.
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Do not use together with strong topical products such as benzoyl peroxide or AHAs without consulting a specialist.
- Approved for treating acne in people aged 9 years and older
-
If severe irritation occurs, stop using it and see a doctor immediately.
Key highlights…
- Helps with comedones and inflammatory acne
- Can be used on both the face and body
(Click here to book an appointment with a doctor or call 088-0410888)
5. Differin – The Most Popular Retinoid for Acne Treatment
Differin. Contains the key active ingredient adapalene 0.1%
Size: 30 g (regular price 930 THB)
(Click here to book an appointment with a doctor or call 088-0410888)
Differin is the brand name of adapalene, a vitamin A derivative used to treat acne, especially comedones and inflammatory acne.
Compared with other retinoids, it causes fewer side effects such as dryness, redness, peeling and irritation. It is generally applied as a thin layer to acne-prone areas once a day at bedtime, and sunscreen must be applied every morning.
-
- Frequency: Apply once a day at bedtime
- Amount: Apply a thin layer over acne-prone areas or the whole face
- Areas to avoid: Avoid the areas around the eyes, lips and creases of the nose
- How to apply: After washing your face and applying your other skincare, apply a thin layer of the medication
- Precautions:
- Sun exposure: Avoid strong sunlight and always apply a high-SPF sunscreen in the morning, as the medication increases sensitivity to light
- Initial breakouts: During the first 1–2 weeks, more comedones than usual may appear. This is normal and is known as “purging”. Keep using the medication; the condition will gradually improve within 6–8 weeks
- Use with other products: Avoid using it together with other exfoliating products, such as salicylic acid or benzoyl peroxide
- Additional tips:
- People with very sensitive skin may mix a small amount of the medication with a moisturizer in a 1:1 ratio to reduce irritation
- May cause dryness, peeling and redness
- If irritation is severe, such as excessive redness or peeling, try leaving it on for only 30 minutes and then washing it off
- Do not use it with scrubs or strong toners for now
- Consult a doctor before use
- Pregnant or breastfeeding women: Do not use, as the medication may be absorbed into the bloodstream and could harm the baby. Stop using the medication at least 1 month before planning a pregnancy
What Does It Help With?
- Reduces clogged pores and inflammation
- Suitable for chronic and frequently recurring acne
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Summary of Topical Acne Treatments
- Retinoids (Differin, Epiduo, Aklief) may cause peeling, dryness and redness at first, which is normal.
- If the irritation becomes unbearable, wash it off, consider pausing the medication, and consult a dermatologist.
- Remember: sunscreen is the best friend of all these medications.
- Never randomly mix several medications, as this may double the stinging and irritation (it’s always best to consult a doctor first).
Recommended Acne Treatment Programs to Use Alongside Topical Medications
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Written by Dr. Supitcha Kamolratanakul
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BOARD CERTIFIED DERMATOLOGIST, AMERICAN BOARD OF DERMATOLOGY IN LASER SURGERY, FELLOWSHIP IN COSMETIC LASER UNIVERSITY OF MIAMI, FELLOW IN DERMATOSURGERY AT RAMATHIBODI HOSPITAL
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