Cream
Acne Cream with Tretinoin
Acne treatment combining antibiotics (clindamycin/erythromycin/ketoconazole) with tretinoin for faster clearance and post-acne healing.
Starting at $101/mo
AcneTopicalGentle
Acne Cream
RxPrescription onlyApplied to the skin · Once a day · Acne · Topical · Gentle
Starting at $101/mo
Acne cream: salicylic acid and niacinamide for oil control and pore unclogging without irritation. Gentler than prescription retinoids.
Choose your plan
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Salicylic acid unclogs pores and reduces sebum
- Niacinamide soothes and supports barrier
- Daily use; works for mild to moderate acne
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is acne cream?
(salicylic acid + niacinamide blend)
This gentle acne cream combines salicylic acid (beta-hydroxy acid) to unplug pores and shed keratin, with niacinamide to soothe inflammation and regulate oil. It is milder than prescription options, making it ideal for people with sensitive skin or those starting acne treatment.
- How it is taken
- Applied to the skin
- How often
- Once a day
- Form
- Acne · Topical · Gentle
OTC
strength for mild to moderate acne; no prescription needed
Results take 2-4 weeks. Daily use is safe; this is not an acute treatment like isotretinoin.
How it works,
week by week.
Week 1
Start with acne cream or low-dose tretinoin. Mild irritation and initial breakout may occur (normal; hang on).
Week 2–4
If using doxycycline, bacteria count decreases. Topical treatment continues; acne begins to flatten.
Week 4–8
New comedones form less frequently. Redness fades. Results become visible.
Month 2–3+
Acne significantly improved. Reduce oral antibiotic if prescribed. Continue topical treatment indefinitely at lower frequency for maintenance.
What you may notice,
and when.
Initial breakout possible
normal with tretinoin; usually resolves by week 4
Patience required
acne improvement takes 4-8 weeks minimum
Steady improvement
new spots form less often; existing marks fade
Sun protection essential
tretinoin and doxycycline increase photosensitivity
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
Topical acne treatments are generally well tolerated; salicylic acid and tretinoin can cause dryness, peeling, and irritation, especially at first. Tretinoin is absolutely contraindicated in pregnancy. Doxycycline is an antibiotic; inform your physician of other medications or allergies, and avoid dairy and calcium supplements (they reduce absorption). Doxycycline increases sun sensitivity, so daily SPF 30+ is essential. Tell your physician about any isotretinoin use history (Accutane). Stop and seek care for severe irritation, signs of allergic reaction, or persistent worsening of acne.
The research behind
skin brighteners.
These creams mix several actives. Azelaic acid, niacinamide, tranexamic acid, vitamin C and hydroquinone have the most human data for dark spots; the rest have little or none.
- Azelaic acidMASI -1.23 vs hydroquinone
Meta-analysis of six randomized trials with 673 people with melasma: azelaic acid lowered the melasma severity score more than hydroquinone (mean difference -1.23, 95% CI -2.05 to -0.40). The trials used 20% azelaic acid; the creams here contain 10%.
Albzea et al., Cureus 2023;15(7):e41796 - Niacinamidereduced spots vs vehicle
A moisturizer with 5% niacinamide was tested in 18 women with hyperpigmentation in a paired design. After 4 weeks, hyperpigmentation fell and skin lightness rose compared with vehicle. The 35–68% figure is from a laboratory model, not a skin result.
Hakozaki et al., Br J Dermatol 2002;147(1):20-31 - Tranexamic acid22 studies, 1,280 patients
A 2024 meta-analysis found tranexamic acid significantly reduced melasma severity, with oral use showing the largest drop; studies were highly heterogeneous. A 2019 systematic review rated it a strong recommendation.
Calacattawi et al., J Dermatolog Treat 2024; Austin et al., J Drugs Dermatol 2019
What the studies found
- Azelaic acid lowered the melasma severity score more than hydroquinone in pooled trials (mean difference -1.23 MASI; Albzea et al., Cureus 2023).
- In a paired study of 18 women, 5% niacinamide lightened hyperpigmentation vs vehicle after 4 weeks (Hakozaki et al., Br J Dermatol 2002).
- Tranexamic acid significantly reduced melasma severity across 22 studies with 1,280 patients (Calacattawi et al., J Dermatolog Treat 2024).
- A six-month trial of 5% vitamin C cream showed clinically apparent improvement in photoaged skin vs vehicle (Humbert et al., Exp Dermatol 2003).
Each cream's actives are at the strength on its label. Trial results are for the single active at the strength studied, not for the mixture. The hydroquinone creams (brightening cream and ClearTone) are prescription drugs; compounded versions were not studied.
What this does not say
- Vitamin C has a six-month double-blind trial of 5% vitamin C cream against vehicle in photoaged neck and arm skin, which reported clinically apparent improvement and a smoother skin relief (Humbert et al., Exp Dermatol 2003). It is not a melasma trial.
- We found no melasma outcome trial for hyaluronic acid, caffeine, dexpanthenol, vitamin E or resveratrol in these creams; they hydrate or support.
- Clindamycin, erythromycin and ketoconazole in the acne creams have evidence in acne, not in brightening.
- Hydroquinone carries a theoretical risk of ochronosis with long use.
The research
behind it.
Salicylic acid penetrates sebaceous follicles and reduces comedones. Niacinamide decreases sebum and inflammation, supporting skin barrier.
This formulation is well tolerated for long-term daily use. For severe acne, your physician may recommend prescription options like tretinoin or oral antibiotics.
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I use Acne Cream?
Applied to the skin, once a day, at bedtime. The starting prescription is 1 mL each time. Your physician sets your own dose and it is printed on your label.
What exactly is in it?
Clindamycin 2%, Erythromycin 4%, Ketoconazole 2%.
How much arrives in each shipment?
1 tube at the starting strength, shipped to your door from a licensed US pharmacy.
When should I use prescription acne treatments instead?
If acne covers much of your face, is deep (cystic), or leaves scarring, your physician will recommend tretinoin or oral medications. Start with this cream for mild acne; escalate if needed after 4-6 weeks.
Can I use all four treatments together?
No. Typical layering: salicylic acid or tretinoin topically, plus doxycycline orally if moderate/severe, plus Clarity for healing. You don't need all four. Your physician chooses a layered plan based on acne severity.
When do I know if a treatment is working?
Give topical treatments 4 weeks and oral antibiotics 8 weeks before deciding if they work. Acne cycles naturally; don't switch treatments too quickly. If no improvement after 8 weeks, your physician will adjust.
What if I develop antibiotic resistance?
Doxycycline courses are typically 3-6 months, then stopped to minimize resistance risk. Continuing topical treatment (tretinoin or salicylic acid) maintains results and prevents relapse.
Can I use acne treatments if I'm using other topicals?
Space them: tretinoin at night, vitamin C or niacinamide in morning. Avoid mixing tretinoin with benzoyl peroxide or retinol. Your physician advises on layering safely.
Acne cream educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
More options
in this area.
Cream
Brightening Cream
Stronger prescription cream for stubborn melasma and dark spots: hydroquinone 6% with tretinoin, hydrocortisone, kojic acid and vitamins C and E. A short course, usually up to 8 weeks.
Starting at $109/mo
Cream
Clarity Cream
Acne and post-acne formula combining azelaic acid, niacinamide, clindamycin, and tretinoin. Anti-inflammatory and cell-renewing.
Starting at $109/mo
Cream
ClearTone Cream
Brightening and anti-inflammatory cream combining azelaic acid, hydroquinone, kojic acid, tranexamic acid, and niacinamide. For post-acne hyperpigmentation.
Starting at $109/mo
References
- 1.Tretinoin in acne: efficacy, retinization, and long-term maintenance. J Clin Aesthet Dermatol, 2017
- 2.Doxycycline in moderate acne: antibiotic and anti-inflammatory mechanisms. Antibiotics, 2019
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.