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Periodic Graphics

Periodic Graphics: The chemistry of acne treatment

Chemical educator and Compound Interest blogger Andy Brunning explains what causes acne and how different medications treat it.

by Andy Brunning, special to C&EN
August 15, 2022 | A version of this story appeared in Volume 100, Issue 28


Infographic on the chemistry of acne treatment. The left-hand column explains how acne forms: dead skin and sebum can block hair follicles, causing sebum to accumulate, and bacteria feed on the sebum and multiply, causing inflammation. The right-hand side of the graphic explains the various treatments. Benzoyl peroxide is a topical antiseptic that oxidizes bacterial proteins; azelaic acid is used as an alternative. Retinoids are also used as topical agents. They regulate the shedding of dead skin cells, thereby preventing blocked follicles, and they reduce inflammation. Antibiotics are used topically or orally to combat acne-causing bacteria; tetracyclines are used for more severe acne. Other options for severe acne include oral isotretinoin or co-cyprindiol, a hormonal treatment that reduces the production of sebum.

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References used to create this graphic:

Graber, Emmy M. “Treating Acne with the Tetracycline Class of Antibiotics: A Review.” Dermatol. Rev. (2021). DOI: 10.1002/der2.49.

Lazic Mosler, Elvira, Christina Leitner, Mohamed A. Gouda, Ben Carter, Alison M. Layton, and Mahmoud Tawfik KhalafAllah. “Topical Antibiotics for Acne.” Cochrane Database Syst. Rev. (2018). DOI: 10.1002/14651858.CD012263.pub2.

Leyden, James, Linda Stein-Gold, and Jonathan Weiss. “Why Topical Retinoids Are Mainstay of Therapy for Acne.” Dermatol. Ther. (2017). DOI: 10.1007/s13555-017-0185-2.

Matin, Taraneh. “Benzoyl Peroxide.” Edited by Marcus B. Goodman. StatPearls. Last modified Oct. 20, 2021.

A collaboration between C&EN and Andy Brunning, author of the popular graphics blog Compound Interest

To see more of Brunning’s work, go to To see all of C&EN’s Periodic Graphics, visit



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