Acne Treatment Evidence Dataset: 58 Treatments, Guideline Strength vs Certainty

Every acne treatment in the TipsForAcne evidence map as one flat table: 58 treatments across 6 categories, each carrying two ratings that are usually blurred together, how strongly the 2024 AAD guideline recommends it and how certain the evidence behind it is. Each row links to its sources. The interactive evidence map is the same data with search and filters.

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strong recommendations rest on high-certainty evidence; the rest are strong on moderate or low certainty.

Quick facts

  • What it is: Acne treatments with guideline strength, evidence certainty, time to effect, cautions and sources
  • Records: 58 treatments
  • Guideline position: 22 evidence judged insufficient, 14 strong recommendation, 11 not assessed in the guideline, 7 conditional recommendation, 2 good practice statement, 1 evidence called conflicting, 1 conditional recommendation against
  • Certainty: 28 not graded (no recommendation to grade), 22 moderate, 5 low, 2 high, 1 very low
  • Primary source: AAD 2024 acne guideline (Reynolds RV et al., JAAD), plus FDA labels and trials per row
  • Formats: CSV, JSON
  • License: CC BY 4.0, attribute TipsForAcne
  • Checked: September 24, 2026

All 58 treatments

TreatmentTypeGuideline positionCertainty of evidenceTime to effectUsed forSources
Adapalene + benzoyl peroxide (fixed dose)
OTC and prescription strengths
Over-the-counter topicalStrong recommendationModerate4–12 weeksRed inflamed spots, Blackheads & whiteheads, Back & chestAAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: Epiduo (adapalene 0.1%/BP 2.5%) gel label
Adapalene 0.1% (OTC retinoid)
Over the counter
Over-the-counter topicalStrong recommendationModerate8–12 weeks, often worse before betterBlackheads & whiteheads, Red inflamed spots, Keeping it clearAAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: adapalene gel 0.1% OTC Drug Facts label
Benzoyl peroxide
Over the counter
Over-the-counter topicalStrong recommendationModerate4–12 weeksRed inflamed spots, Blackheads & whiteheads, Back & chest, Keeping it clearAAD 2024 acne guideline (Reynolds RV et al., JAAD); Ghannoum M et al. Criticality of benzoyl peroxide and antibiotic fixed combinations, Clin Cosmet Investig Dermatol 2025
Clindamycin + benzoyl peroxide (fixed dose)
Prescription
Prescription topicalStrong recommendationModerate6–12 weeksRed inflamed spots, Back & chestAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Clindamycin + tretinoin (fixed dose)
Prescription
Prescription topicalStrong recommendationModerate8–12 weeksRed inflamed spots, Blackheads & whiteheadsAAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: Ziana (clindamycin 1.2%/tretinoin 0.025%) gel label
Oral doxycycline
Prescription
Oral medicationStrong recommendationModerate6–12 weeks; usually capped at 3–4 monthsRed inflamed spots, Deep / cystic, Back & chestAAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: doxycycline hyclate tablets label
Tazarotene
Prescription
Prescription topicalStrong recommendationModerate8–12 weeksBlackheads & whiteheads, Red inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: tazarotene cream 0.05% and 0.1% label
Topical clindamycin
Prescription
Prescription topicalStrong recommendationModerate6–12 weeksRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD); Ghannoum M et al. Clin Cosmet Investig Dermatol 2025
Topical dapsone
Prescription
Prescription topicalStrong recommendationModerate8–12 weeksRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD); Dubina MI, Fleischer AB. Interaction of topical sulfacetamide and dapsone with benzoyl peroxide, Arch Dermatol 2009
Topical erythromycin
Prescription
Prescription topicalStrong recommendationModerate6–12 weeksRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Topical minocycline foam
Prescription
Prescription topicalStrong recommendationModerate8–12 weeksRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Tretinoin
Prescription
Prescription topicalStrong recommendationModerate8–12 weeks, often worse before betterBlackheads & whiteheads, Red inflamed spots, Keeping it clear, Dark marksAAD 2024 acne guideline (Reynolds RV et al., JAAD); Bulengo-Ransby SM et al. Tretinoin for post-inflammatory hyperpigmentation, N Engl J Med 1993
Tretinoin + benzoyl peroxide (encapsulated, Twyneo)
Prescription
Prescription topicalStrong recommendationModerate8–12 weeksRed inflamed spots, Blackheads & whiteheadsAAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: Twyneo (tretinoin 0.1%/BP 3%) cream label
Trifarotene
Prescription
Prescription topicalStrong recommendationModerate8–12 weeksBlackheads & whiteheads, Red inflamed spots, Back & chestAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Intralesional corticosteroid injection
In clinic
In-clinic procedureGood practice statement—24–72 hours for one lesionDeep / cysticAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Oral isotretinoin
Prescription, with a pregnancy prevention programme
Oral medicationGood practice statement—4–6 months for a typical course; improvement often continues after stoppingDeep / cystic, Red inflamed spots, Back & chest, ScarsAAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: Accutane (isotretinoin) capsules label
Clascoterone 1% cream (Winlevi)
Prescription
Prescription topicalConditional recommendationHigh12 weeksHormonal pattern, Red inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD); Rosette C et al. Cortexolone 17α-propionate, J Drugs Dermatol 2019
Oral sarecycline
Prescription
Oral medicationConditional recommendationHigh12 weeksRed inflamed spots, Deep / cysticAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Azelaic acid
OTC 10% and prescription 15–20%
Over-the-counter topicalConditional recommendationModerate4–12 weeks; longer for marksRed inflamed spots, Blackheads & whiteheads, Dark marksAAD 2024 acne guideline (Reynolds RV et al., JAAD); Cochrane 2020: azelaic acid, salicylic acid, nicotinamide, sulphur, zinc, AHA for acne (Liu H et al.); King S et al. Systematic review of azelaic acid, J Cosmet Dermatol 2023
Combined oral contraceptive pills
Prescription
Oral medicationConditional recommendationModerate3–6 monthsHormonal pattern, Red inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Oral minocycline
Prescription
Oral medicationConditional recommendationModerate6–12 weeksRed inflamed spots, Deep / cysticAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Spironolactone
Prescription
Oral medicationConditional recommendationModerate3–6 monthsHormonal pattern, Red inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD); Plovanich M et al. Low usefulness of potassium monitoring, JAMA Dermatol 2015
Salicylic acid
Over the counter
Over-the-counter topicalConditional recommendationLow4–8 weeksBlackheads & whiteheads, Keeping it clearAAD 2024 acne guideline (Reynolds RV et al., JAAD); Cochrane 2020: azelaic acid, salicylic acid, nicotinamide, sulphur, zinc, AHA for acne (Liu H et al.)
Low-glycaemic-load diet
Self-directed
Diet & supplementsEvidence called conflicting—10–12 weeks in the trialsRed inflamed spots, Blackheads & whiteheadsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Chemical peels for active acne
In clinic
In-clinic procedureEvidence judged insufficient—A series of 3–6 sessionsBlackheads & whiteheads, Red inflamed spots, Dark marksAAD 2024 acne guideline (Reynolds RV et al., JAAD); Chen X et al. Chemical peels for acne vulgaris: systematic review and meta-analysis, BMJ Open 2018
Chocolate avoidance
Self-directed
Diet & supplementsEvidence judged insufficient—UnclearRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Comedo extraction
In clinic
In-clinic procedureEvidence judged insufficient—Immediate for the lesion extractedBlackheads & whiteheadsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Flutamide
Prescription
Oral medicationEvidence judged insufficient—UnclearHormonal patternAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Lasers and light devices for active acne
In clinic
In-clinic procedureEvidence judged insufficient—A series of sessionsRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Low-dairy or low-whey diet
Self-directed
Diet & supplementsEvidence judged insufficient—UnclearRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Metformin
Prescription
Oral medicationEvidence judged insufficient—Unclear for acneHormonal patternAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Omega-3 fatty acid supplements
Over the counter
Diet & supplementsEvidence judged insufficient—UnclearRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Oral azithromycin
Prescription
Oral medicationEvidence judged insufficient—VariableRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Oral corticosteroids
Prescription
Oral medicationEvidence judged insufficient—Days, for flaresDeep / cysticAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Oral or topical zinc
Over the counter
Diet & supplementsEvidence judged insufficient—UnclearRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD); Cochrane 2020: azelaic acid, salicylic acid, nicotinamide, sulphur, zinc, AHA for acne (Liu H et al.)
Oral pantothenic acid (vitamin B5)
Over the counter
Diet & supplementsEvidence judged insufficient—UnclearRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Photodynamic therapy
In clinic
In-clinic procedureEvidence judged insufficient—A series of sessionsRed inflamed spots, Deep / cysticAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Resorcinol
Over the counter
Over-the-counter topicalEvidence judged insufficient—UnclearBlackheads & whiteheadsAAD 2024 acne guideline (Reynolds RV et al., JAAD); FDA OTC Monograph M006, topical acne drug products
Sodium sulfacetamide
OTC and prescription
Over-the-counter topicalEvidence judged insufficient—UnclearRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: sodium sulfacetamide 10% / sulfur 5% label
Sulfur
Over the counter
Over-the-counter topicalEvidence judged insufficient—UnclearRed inflamed spots, Blackheads & whiteheadsAAD 2024 acne guideline (Reynolds RV et al., JAAD); Cochrane 2020: azelaic acid, salicylic acid, nicotinamide, sulphur, zinc, AHA for acne (Liu H et al.)
Tea tree oil
Over the counter
Over-the-counter topicalEvidence judged insufficient—Slower than benzoyl peroxide in the one comparison trialRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD); Bassett IB et al. Tea-tree oil vs benzoyl peroxide, Med J Aust 1990
Topical glycolic acid
Over the counter
Over-the-counter topicalEvidence judged insufficient—UnclearBlackheads & whiteheads, Dark marksAAD 2024 acne guideline (Reynolds RV et al., JAAD); Cochrane 2020: azelaic acid, salicylic acid, nicotinamide, sulphur, zinc, AHA for acne (Liu H et al.)
Topical green tea
Over the counter
Over-the-counter topicalEvidence judged insufficient—UnclearRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Topical niacinamide
Over the counter
Over-the-counter topicalEvidence judged insufficient—8–12 weeks if at allRed inflamed spots, Dark marksAAD 2024 acne guideline (Reynolds RV et al., JAAD); Cochrane 2020: azelaic acid, salicylic acid, nicotinamide, sulphur, zinc, AHA for acne (Liu H et al.); Kaewsanit T et al. BP 2.5% + niacinamide 5% vs BP alone, J Clin Aesthet Dermatol 2021
Trimethoprim/sulfamethoxazole
Prescription
Oral medicationEvidence judged insufficient—VariableRed inflamed spots, Deep / cysticAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Witch hazel
Over the counter
Over-the-counter topicalEvidence judged insufficient—UnclearRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Azelaic acid for post-inflammatory hyperpigmentation
OTC 10% and prescription 15–20%
Scars & marksNot assessed in the guidelineModerate8–16 weeksDark marksKircik LH. Azelaic acid gel 15% for post-inflammatory hyperpigmentation, J Drugs Dermatol 2011
Fractional laser resurfacing for acne scars
In clinic
Scars & marksNot assessed in the guidelineModerate3–5 sessions; months of remodelling afterScarsWang Y et al. Network meta-analysis of six photoelectric therapies for atrophic acne scars, IJDVL; Kaushik SB, Alexis AF. Nonablative fractional laser resurfacing in skin of color, J Clin Aesthet Dermatol
Sunscreen for post-inflammatory hyperpigmentation
Over the counter
Scars & marksNot assessed in the guidelineModeratePrevention; months to see the differenceDark marksDumbuya H et al. Iron-oxide containing formulations against visible-light-induced pigmentation, J Drugs Dermatol 2020
Topical tretinoin for post-inflammatory hyperpigmentation
Prescription
Scars & marksNot assessed in the guidelineModerate10–40 weeksDark marksBulengo-Ransby SM et al. N Engl J Med 1993
Hydroquinone (with tretinoin and a steroid, Kligman-type)
Prescription
Scars & marksNot assessed in the guidelineLow8–12 weeks, short-term useDark marksKligman AM, Willis I. A new formula for depigmenting human skin, Arch Dermatol 1975; Alghamdi SM et al. Kligman’s formula meta-analysis, Arch Dermatol Res 2025
Microneedling for atrophic acne scars
In clinic
Scars & marksNot assessed in the guidelineLow3–6 sessions, months apartScarsShen YC et al. Microneedling monotherapy for acne scar: systematic review and meta-analysis, Aesthetic Plast Surg 2022
Subcision for tethered (rolling) scars
In clinic
Scars & marksNot assessed in the guidelineLow1–3 sessionsScarsBhargava S et al. Subcision and microneedling as an inexpensive and safe combination, J Clin Aesthet Dermatol 2019
TCA CROSS for ice-pick scars
In clinic
Scars & marksNot assessed in the guidelineVery low3–6 sessions, weeks apartScarsDermNet: TCA CROSS
Clindamycin + adapalene + benzoyl peroxide (triple, Cabtreo)
Prescription
Prescription topicalNot assessed in the guideline—8–12 weeksRed inflamed spots, Blackheads & whiteheads, Back & chestAAD 2024 acne guideline (Reynolds RV et al., JAAD)
Hydrocolloid pimple patches
Over the counter
Over-the-counter topicalNot assessed in the guideline—6–24 hours per lesionRed inflamed spotsCleveland Clinic: How do pimple patches work?
Moisturiser and broad-spectrum sunscreen
Over the counter
Over-the-counter topicalNot assessed in the guideline—Supportive, not curativeKeeping it clear, Dark marksKim MR, Kerrouche N. BP 5% gel with cleanser and SPF 30 moisturiser, J Dermatolog Treat 2018; Draelos ZD et al. Ceramide-containing adjunctive skin care during acne treatment, J Drugs Dermatol 2023
Pneumatic broadband light added to adapalene 0.3%
In clinic
In-clinic procedureConditional recommendation AGAINSTLown/aRed inflamed spotsAAD 2024 acne guideline (Reynolds RV et al., JAAD)

How we built this

Each treatment was placed against the recommendation that covers it in the 2024 AAD guideline, recording the panel’s strength (strong, conditional, good practice statement, recommendation against, or no recommendation) and the GRADE certainty (high, moderate, low, very low) as two separate fields, exactly as the guideline reports them. Where a treatment is not addressed by the guideline, the position is recorded as such rather than inferred. Time to effect, cautions and pregnancy notes come from the FDA label or the cited trial. Every row’s sources are listed in the table and in the CSV.

What this cannot tell you

A guideline position is a population-level judgment, not a prescription. “Strong, low certainty” means the panel was confident despite thin trials, which is common for older, well-established treatments; it is not a warning. Rows for diet and procedures reflect what the guideline could and could not conclude, and several read “insufficient evidence” on purpose. Nothing here has been reviewed by a clinician; it is general information, not medical advice.

Use this data

The facts in this table (what a guideline recommends, what a label says, what a study found) are not ours to own; repeat them anywhere. Our wording, table and layout are free to reuse, including commercially, under CC BY 4.0. Attribution with a link is all we ask.

Live endpoints: /acne-evidence-map.json · /acne-evidence-map.csv (generated from the evidence map on every request, CORS open)

Download CSV of the Acne Treatment Evidence: Guideline Strength and Certainty dataset · Live JSON: /data/acne-treatment-evidence.json for the Acne Treatment Evidence: Guideline Strength and Certainty dataset (stable URL, CORS open; the same records are embedded in this page as tfa-ds-evidence-json) · All TipsForAcne datasets

Cite as: TipsForAcne, “Acne Treatment Evidence Dataset: 58 Treatments, Guideline Strength vs Certainty”, tipsforacne.com/data/acne-treatment-evidence/ (checked 2026-09-24). General information, not medical advice.

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