in Acne Medications
Let’s cut right to the chase—the term ‘active ingredients’ has real meaning. An active ingredient is an ingredient that’s believed to give the product in question its intended effect—and these ingredients tend to be FDA-regulated. In a prescription product, they are proven to be effective, and safety and tolerability issues are defined based on multiple clinical studies. In an over-the-counter product, it’s a bit more…complicated. Here’s what’s worth knowing.
Both prescription products and over-the-counter acne products contain active ingredients
As I mentioned, you may see active ingredients listed on the label of both prescription products and their over-the-counter counterparts. The difference? Sometimes it’s the total percentage or concentration of the active ingredient. While there are no overarching percentage caps that define an ‘active’ ingredient, prescription-strength acne treatment formulas may often contain higher concentrations. Take, for example, salicylic acid, an active ingredient commonly found in acne medications and OTC products. Over-the-counter formulas can contain up to two percent, whereas in a prescription acne medication, this can be a lot higher.  Another good example is adapalene. You can get it over the counter at a 0.1 percent concentration, but with prescription versions, you can get 0.3 percent of the active ingredient in your acne treatment.  It’s also worth noting that not all types of over-the-counter products are going to have active ingredients. You’re not going to see any active ingredients listed on a basic moisturizer or cleanser.
While there are no overarching percentage caps that define an ‘active’ ingredient, prescription-strength acne treatment formulas may often contain higher concentrations.
There are plenty of active ingredients available in acne medications, treatments, and producxts that are good for acne-prone skin
The two we talked about earlier—salicylic acid and adapalene—are big ones, but there are many others including benzoyl peroxide and tretinoin. (Tretinoin is an example of an active ingredient that’s only available by prescription.) Oral acne treatments that we use, such as oral isotretinoin and antibiotics, as well as topical antibiotics for acne, are also considered active ingredients and are available by prescription only. Every medication I prescribe and recommend to my acne patients contains active ingredients.
When it comes to active ingredients in acne medications and products, the formulation matters
The concentration of active ingredients in acne medicine is important, but there’s a lot more that goes into a final product, both when it comes to making sure that it works and that it’s going to be safe and well tolerated by the skin. Think of it this way: If you had a grandmother or aunt who made incredible spaghetti, it would only taste the specific way it does when she makes it. If someone else makes it—even if they use the same ingredients and follow the same basic recipe—it’s probably not going to turn out the same way because they’re not as adept at making the same formula for that delicious bowl of spaghetti. So along with which active ingredients you’re choosing, you also need to consider the entire formulation. Prescriptions have been studied and gone through a rigorous process and many steps to get FDA-approval, whereas over-the-counter products haven’t been studied to quite the same extent, though they do have to meet certain safety standards.
James Del Rosso, D.O.
Dr. Jim Del Rosso is an internationally renowned dermatologist who has been practicing dermatology since 1986 and a member of the Acne Store Board of Dermatologists. He is Clinical Editor-in-Chief of the Journal of Clinical and Aesthetic Dermatology, has published multiple peer-reviewed articles and textbook chapters, and was President of the American Acne & Rosacea Society, American Society of Mohs Surgery, and the American Osteopathic College of Dermatology. He is Adjunct Clinical Professor of Dermatology at the Touro University Nevada in Henderson, Nevada. Currently, Dr. Del Rosso is Research Director of JDR Dermatology Research and practices at Thomas Dermatology in Las Vegas, Nevada and also serves as Senior Vice President of Clinical Research and Strategic Development at Advanced Dermatology and Cosmetic Surgery in Maitland, Florida. He served as Head of the Section of Dermatology at the Ohio University College of Osteopathic Medicine after receiving his D.O. degree from the same medical school in Athens, Ohio, interning at Doctors Hospital in Columbus, completing a dermatology residency at Atlantic Skin Disease and Skin Surgery in Fort Lauderdale, Florida, and completing a fellowship in Mohs micrographic surgery and cutaneous oncology at OSU.
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