As dermatologists, we often combine prescription systemic antibiotics, such as doxycycline or minocycline, with surface medications. Typical topical medications are benzoyl peroxide as a lotion or cleanser, surface antibiotics such as clindamycin and erythromycin, tretinoin, Differin, and newer medications such as Aczone gel.
The only over-the-counter effective medication is benzoyl peroxide. However, you need to be careful to not let it overly dry your skin or stain fabrics. We do not feel that products such as Proactive are worth purchasing.
If excess testosterone is present, then investigation is needed to determine the cause. Oral spironolactone is a prescription oral medication that can block the effects of mild excess testosterone.
Poor skin hygiene can provoke acne if body areas remain hot and sweaty. It is best to shower each day and use a mild soap such as Dove. Do not overly wash or scrub your skin. Oil-free cosmetics and moisturizers are much better than standard products.
If the acne is very red or cystic, it is best to seek out the care of a dermatologist.