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
| Treatment | Type | Guideline position | Certainty of evidence | Time to effect | Used for | Sources |
|---|---|---|---|---|---|---|
| Adapalene + benzoyl peroxide (fixed dose) OTC and prescription strengths | Over-the-counter topical | Strong recommendation | Moderate | 4–12 weeks | Red inflamed spots, Blackheads & whiteheads, Back & chest | AAD 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 topical | Strong recommendation | Moderate | 8–12 weeks, often worse before better | Blackheads & whiteheads, Red inflamed spots, Keeping it clear | AAD 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 topical | Strong recommendation | Moderate | 4–12 weeks | Red inflamed spots, Blackheads & whiteheads, Back & chest, Keeping it clear | AAD 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 topical | Strong recommendation | Moderate | 6–12 weeks | Red inflamed spots, Back & chest | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Clindamycin + tretinoin (fixed dose) Prescription | Prescription topical | Strong recommendation | Moderate | 8–12 weeks | Red inflamed spots, Blackheads & whiteheads | AAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: Ziana (clindamycin 1.2%/tretinoin 0.025%) gel label |
| Oral doxycycline Prescription | Oral medication | Strong recommendation | Moderate | 6–12 weeks; usually capped at 3–4 months | Red inflamed spots, Deep / cystic, Back & chest | AAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: doxycycline hyclate tablets label |
| Tazarotene Prescription | Prescription topical | Strong recommendation | Moderate | 8–12 weeks | Blackheads & whiteheads, Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: tazarotene cream 0.05% and 0.1% label |
| Topical clindamycin Prescription | Prescription topical | Strong recommendation | Moderate | 6–12 weeks | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD); Ghannoum M et al. Clin Cosmet Investig Dermatol 2025 |
| Topical dapsone Prescription | Prescription topical | Strong recommendation | Moderate | 8–12 weeks | Red inflamed spots | AAD 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 topical | Strong recommendation | Moderate | 6–12 weeks | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Topical minocycline foam Prescription | Prescription topical | Strong recommendation | Moderate | 8–12 weeks | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Tretinoin Prescription | Prescription topical | Strong recommendation | Moderate | 8–12 weeks, often worse before better | Blackheads & whiteheads, Red inflamed spots, Keeping it clear, Dark marks | AAD 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 topical | Strong recommendation | Moderate | 8–12 weeks | Red inflamed spots, Blackheads & whiteheads | AAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: Twyneo (tretinoin 0.1%/BP 3%) cream label |
| Trifarotene Prescription | Prescription topical | Strong recommendation | Moderate | 8–12 weeks | Blackheads & whiteheads, Red inflamed spots, Back & chest | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Intralesional corticosteroid injection In clinic | In-clinic procedure | Good practice statement | — | 24–72 hours for one lesion | Deep / cystic | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Oral isotretinoin Prescription, with a pregnancy prevention programme | Oral medication | Good practice statement | — | 4–6 months for a typical course; improvement often continues after stopping | Deep / cystic, Red inflamed spots, Back & chest, Scars | AAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: Accutane (isotretinoin) capsules label |
| Clascoterone 1% cream (Winlevi) Prescription | Prescription topical | Conditional recommendation | High | 12 weeks | Hormonal pattern, Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD); Rosette C et al. Cortexolone 17α-propionate, J Drugs Dermatol 2019 |
| Oral sarecycline Prescription | Oral medication | Conditional recommendation | High | 12 weeks | Red inflamed spots, Deep / cystic | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Azelaic acid OTC 10% and prescription 15–20% | Over-the-counter topical | Conditional recommendation | Moderate | 4–12 weeks; longer for marks | Red inflamed spots, Blackheads & whiteheads, Dark marks | AAD 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 medication | Conditional recommendation | Moderate | 3–6 months | Hormonal pattern, Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Oral minocycline Prescription | Oral medication | Conditional recommendation | Moderate | 6–12 weeks | Red inflamed spots, Deep / cystic | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Spironolactone Prescription | Oral medication | Conditional recommendation | Moderate | 3–6 months | Hormonal pattern, Red inflamed spots | AAD 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 topical | Conditional recommendation | Low | 4–8 weeks | Blackheads & whiteheads, Keeping it clear | AAD 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 & supplements | Evidence called conflicting | — | 10–12 weeks in the trials | Red inflamed spots, Blackheads & whiteheads | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Chemical peels for active acne In clinic | In-clinic procedure | Evidence judged insufficient | — | A series of 3–6 sessions | Blackheads & whiteheads, Red inflamed spots, Dark marks | AAD 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 & supplements | Evidence judged insufficient | — | Unclear | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Comedo extraction In clinic | In-clinic procedure | Evidence judged insufficient | — | Immediate for the lesion extracted | Blackheads & whiteheads | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Flutamide Prescription | Oral medication | Evidence judged insufficient | — | Unclear | Hormonal pattern | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Lasers and light devices for active acne In clinic | In-clinic procedure | Evidence judged insufficient | — | A series of sessions | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Low-dairy or low-whey diet Self-directed | Diet & supplements | Evidence judged insufficient | — | Unclear | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Metformin Prescription | Oral medication | Evidence judged insufficient | — | Unclear for acne | Hormonal pattern | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Omega-3 fatty acid supplements Over the counter | Diet & supplements | Evidence judged insufficient | — | Unclear | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Oral azithromycin Prescription | Oral medication | Evidence judged insufficient | — | Variable | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Oral corticosteroids Prescription | Oral medication | Evidence judged insufficient | — | Days, for flares | Deep / cystic | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Oral or topical zinc Over the counter | Diet & supplements | Evidence judged insufficient | — | Unclear | Red inflamed spots | AAD 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 & supplements | Evidence judged insufficient | — | Unclear | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Photodynamic therapy In clinic | In-clinic procedure | Evidence judged insufficient | — | A series of sessions | Red inflamed spots, Deep / cystic | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Resorcinol Over the counter | Over-the-counter topical | Evidence judged insufficient | — | Unclear | Blackheads & whiteheads | AAD 2024 acne guideline (Reynolds RV et al., JAAD); FDA OTC Monograph M006, topical acne drug products |
| Sodium sulfacetamide OTC and prescription | Over-the-counter topical | Evidence judged insufficient | — | Unclear | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD); DailyMed: sodium sulfacetamide 10% / sulfur 5% label |
| Sulfur Over the counter | Over-the-counter topical | Evidence judged insufficient | — | Unclear | Red inflamed spots, Blackheads & whiteheads | AAD 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 topical | Evidence judged insufficient | — | Slower than benzoyl peroxide in the one comparison trial | Red inflamed spots | AAD 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 topical | Evidence judged insufficient | — | Unclear | Blackheads & whiteheads, Dark marks | AAD 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 topical | Evidence judged insufficient | — | Unclear | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Topical niacinamide Over the counter | Over-the-counter topical | Evidence judged insufficient | — | 8–12 weeks if at all | Red inflamed spots, Dark marks | AAD 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 medication | Evidence judged insufficient | — | Variable | Red inflamed spots, Deep / cystic | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Witch hazel Over the counter | Over-the-counter topical | Evidence judged insufficient | — | Unclear | Red inflamed spots | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Azelaic acid for post-inflammatory hyperpigmentation OTC 10% and prescription 15–20% | Scars & marks | Not assessed in the guideline | Moderate | 8–16 weeks | Dark marks | Kircik LH. Azelaic acid gel 15% for post-inflammatory hyperpigmentation, J Drugs Dermatol 2011 |
| Fractional laser resurfacing for acne scars In clinic | Scars & marks | Not assessed in the guideline | Moderate | 3–5 sessions; months of remodelling after | Scars | Wang 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 & marks | Not assessed in the guideline | Moderate | Prevention; months to see the difference | Dark marks | Dumbuya H et al. Iron-oxide containing formulations against visible-light-induced pigmentation, J Drugs Dermatol 2020 |
| Topical tretinoin for post-inflammatory hyperpigmentation Prescription | Scars & marks | Not assessed in the guideline | Moderate | 10–40 weeks | Dark marks | Bulengo-Ransby SM et al. N Engl J Med 1993 |
| Hydroquinone (with tretinoin and a steroid, Kligman-type) Prescription | Scars & marks | Not assessed in the guideline | Low | 8–12 weeks, short-term use | Dark marks | Kligman 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 & marks | Not assessed in the guideline | Low | 3–6 sessions, months apart | Scars | Shen 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 & marks | Not assessed in the guideline | Low | 1–3 sessions | Scars | Bhargava 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 & marks | Not assessed in the guideline | Very low | 3–6 sessions, weeks apart | Scars | DermNet: TCA CROSS |
| Clindamycin + adapalene + benzoyl peroxide (triple, Cabtreo) Prescription | Prescription topical | Not assessed in the guideline | — | 8–12 weeks | Red inflamed spots, Blackheads & whiteheads, Back & chest | AAD 2024 acne guideline (Reynolds RV et al., JAAD) |
| Hydrocolloid pimple patches Over the counter | Over-the-counter topical | Not assessed in the guideline | — | 6–24 hours per lesion | Red inflamed spots | Cleveland Clinic: How do pimple patches work? |
| Moisturiser and broad-spectrum sunscreen Over the counter | Over-the-counter topical | Not assessed in the guideline | — | Supportive, not curative | Keeping it clear, Dark marks | Kim 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 procedure | Conditional recommendation AGAINST | Low | n/a | Red inflamed spots | AAD 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.