Whiteheads, Blackheads, Pimples: A Guide to Treating Acne at Home

Whether you are a teen with homecoming around the corner or an adult heading into a job interview, few things feel worse than waking up with a pimple—or a full-on breakout.

So what over-the-counter (OTC) treatment should you reach for when acne strikes? A pimple patch? A cream? A wash? Should you try and pop that whitehead or blackhead?

Yale Medicine dermatologist Sara Perkins, MD, says the good news is that there are plenty of effective options you can buy at the drugstore. The challenge? Sorting through the overwhelming number of products.

“There are so many good products over the counter, so that’s the plus side,” Dr. Perkins says. “The downside is that because there are so many, it can be difficult to know where to start. And, unfortunately, no matter what TikTok tells you, there’s just not anything that’s going to take away your acne before prom tomorrow. It takes time and consistency.”

She adds that less is more when it comes to many of the products you can use to treat acne. “Many can be irritating to the skin. You don’t want to try too many things at the same time,” she says. “That could trigger irritation like dryness, flaking, peeling in the skin, and then sometimes there's even concern that if you excessively dry out your skin, you might encourage more oil production.”

Acne vulgaris—the medical term for common acne—is one of the most common skin disorders, affecting 85% of people between the ages of 12 and 24. While it’s often thought of as primarily a problem for adolescents, more than 25% of women and 12% of men in their 40s still deal with acne.

“I see many adults, especially adult women, who never had acne as a teenager,” Dr. Perkins says. “Acne is not one-size-fits-all. It can affect teenagers, young adults, or even parents of teens.”

Acne occurs when pores become blocked by excess oil and dead skin cells, creating the perfect environment for bacteria to grow. Hormones, genetics, and environmental triggers all play a role, Dr. Perkins says.

Acne is characterized by pimples, blackheads, and whiteheads on the face, back, and chest. Blackheads and whiteheads are known as comedones, or clogged pores. Inflammatory acne involves red, swollen, and sore bumps that may appear as pus-filled pimples (pustules) or pus-free bumps (papules). When acne becomes severe, cysts and nodules can form under the skin and sometimes cause permanent scarring.

For mild acne, particularly if it’s mainly blackheads and whiteheads, Dr. Perkins recommends first trying a topical retinoid cream called adapalene (sold under brand names including Differin and Effaclar). Retinoids are compounds derived from vitamin A and help your skin replace older cells with newer ones more quickly, a process that can unclog pores, soften the appearance of wrinkles, and even out skin tone over time.

Because retinoids can irritate the skin, Dr. Perkins recommends starting slowly. “Use a pea-sized amount for your entire face. Dab each cheek and the forehead with that small amount, and rub it into your face. It will feel like you aren’t putting much on at all, but that’s enough.”

Often, Dr. Perkins has people use adapalene every other night for a few weeks. If the skin is not too irritated, they can switch to using it nightly, after washing their face. She recommends following up with a gentle moisturizer and sticking to using adapalene at night-time, as it may make skin more sensitive to sunlight.

There are stronger strengths of adapalene available by prescription, but if you decide to you the OTC version first, Dr. Perkins recommends using it for a few months before trying a prescription strength, as it can take a little while to see effects.

For mild acne, another option is to try a face wash that contains a beta hydroxy acid such as salicylic acid, Dr. Perkins says. Salicylic acid helps exfoliate the skin’s surface to remove dead skin cells and cut down on oil production.

“A product with 2% salicylic acid is a good place to start,” Dr. Perkins says. “Use it two to three times per week. It helps with skin turnover, preventing cells from getting sticky and clogging pores. I often recommend washing with salicylic acid in the morning and applying the retinoid, like adapalene, at night to limit skin irritation.”

For those who have more red, inflammatory acne, Dr. Perkins recommends trying products that contain benzoyl peroxide, which is available in washes and creams. Benzoyl peroxide can help by killing acne-causing bacteria and reducing inflammation.

If you’ve tried OTC products for six to eight weeks and haven’t achieved the results you want or if your acne is scarring your skin or affecting your confidence, it may be time see a dermatologist.

Dr. Perkins often asks her patients to rate how bothered they are by their acne on a scale of one to 10. “If someone says they’re a 10 and doesn’t want to go to school tomorrow because of how their skin looks, they need more aggressive management,” she says.

There are many options when it comes to prescriptions for acne, including tretinoin, a topical retinoid sold under the brand name Retin-A. There’s also isotretinoin, an oral retinoid formerly sold under the brand name Accutane, which is highly effective but requires close monitoring due to side effects.

Additional medications include spironolactone, an oral medication that blocks certain hormones in the body that may contribute to acne, especially in women. Antibiotics are also sometimes used for acne treatment. “I still sometimes do a course of antibiotics, if we need to calm down the acne, and then we maintain them on topicals,” Dr. Perkins says. “The challenge with antibiotics is that they’re helpful but we don’t want to keep people on them longterm, and if you stop them, the acne tends to come back.”

Additionally, Yale Medicine dermatologists offer in-office procedures such as chemical peels, light-based therapies, and steroid injections for acne that is not responding to other treatments.

People are often tempted to take acne clearing into their own hands—literally, in the form of popping pimples. Dr. Perkins advises against this as it increases the risk of introducing bacteria into your skin, which can lead to infection and scarring.

“The more you squeeze a spot, the more it can become inflamed,” she says.

Instead, Dr. Perkins recommends pimple patches—small, sticker-like bandages that cover the acne spot. Sold at most drugstores, they contain hydrocolloid, a material often used in wound dressing to absorb fluid and form a protective gel over an affected area. Some patches also contain salicylic acid for an added acne-fighting boost. Patches are typically worn overnight and can speed up healing and reduce irritation.

Playing sports and working out can also worsen acne. “You’re getting sweaty and dirty and you might not get to wash your face for a while. Plus, sometimes equipment, like helmets with chin pads, can stick to the skin and cause acne,” Dr. Perkins says.

The best thing to do, she says, is to wash your face as soon as possible after a workout. But if that’s not possible, she suggests keeping a pack of gentle cleansing cloths in your gym bag so you can wipe off sweat and dirt on the go.

Ultimately, when it comes to acne, Dr. Perkins says it’s important to be patient. Whether you’re battling blackheads, whiteheads, or inflamed breakouts, consistency matters most. “Pick one product to try and give it a good two months before moving on if it’s not working,” she advises.

“You don’t want to try 17 different things at the same time. But if you’re not making progress with what you use, see a dermatologist,” Dr. Perkins adds. “If you notice scarring or you’re extremely bothered by your acne, don’t wait to see someone.”