Official ACNE Treatment Tier List

Hinzugefügt: 2026-05-31

[00:00:00]All right, ladies, gents, boys, girls, welcome to the official acne on cycle tier list management. Basically, every single way that I deem valid to fix acne is on this list. If it's not on this list, I either forgot it because I'm [ __ ] um or it doesn't work. So, if there's something I forgot, let me know in the comments. But this is basically all the ways to treat um in my opinion and induced acne. So if you have like this is not like an actual this is acne in the scope of DHT DHT derivatives hormonal imbalance etc. If you have some sort of like [ __ ] inflammatory based acne from like I don't even know like diet look some of this stuff will help. Yeah but obviously address the underlying issue first. So starting off with number one finasteride. Finasteride is an acne treatment. Oh [ __ ] Oh wait we got like this. All right, finasteride is an acne treatment in my opinion is uh pretty much S tier. Now DHT itself is basically the root of all evil when it comes to acne just due to how it activates really upregulation of nothing you want um all your sebaceous filaments uh literally everything like everything that you could imagine being tied um to acne and sebum production removing DHT will likely remove a large portion of the issue. Now obviously finasteride itself since it is acting systemically does come with the risk of of more side effects of reducing DHT in your entire body and along with that you're now rate limiting the conversion of other neurosteroids that go through the five AR pathway. So there is a little bit of spillover into other things here.

[00:01:37]Actually now that I'm talking about it I'm putting in a tier. Um there is a little bit of spillover into other metrics other categories in your body. Um, but generally speaking, being able to control DHT, um, indogenous DHT that is from testosterone, uh, will likely lower your overall acne burden, especially if you're running pretty much highdose androgens year round, whether you're on like TRT plus like 250 300 milligrams year round. um removing a lot of that DHT from the equation to sort of limit inflammation and and limit sebaceic activity and reduce sebum production overall will help you a lot. Dutasteride basically everything finasteride does except to a much more extreme degree. Uh dutasteride actually can be so extreme when it comes to shrinking um the amount of sebum that you have, it can actually reduce the size of your nose um because your nose is actually made up of just basically sebaceous filament. Um, so when you remove all that, you can basically shrink the size of your nose um, using dutasteride. Problem with dutastasteride is that it's obviously going to hit basically all isoforms of the five AR enzyme to a lot greater of a degree, meaning the potential for side effects is obviously incredibly elevated compared to finasteride. Um, so if you weren't already suffering from neurosteroid depletion from using steroids, um, once you introduce a extreme 5 AR rate limiter into the equation, you're basically going to have zero alopregnol alolone. So, for what that's worth, uh, most guys who wind up using dutastasteride, I think, kind of have to cope themselves into thinking they're not having side effects when in reality they probably are having side effects. Um, does it work incredibly well for treating acne? Uh, yes. Especially if your acne is coming from extreme highdosese testosterone cycles, like multiple grams of gear. Um, but if that's not the case, I I I don't even I I wouldn't consider this as an option. I would probably resort to a million other things on this list um before I use dutasteride to treat acne from purely testosterone or testosterone derivatives. So for that reason I'm putting uh dutasteride in Dtier. Now CB0301 uh this is a topical anti-androgen. So basically it does kind of all the things finasteride does from a blocking DHT at the receptor level except finasteride just reduces the actual burden of DHT in your body. uh CB0301 basically prevents DHT from binding to the actual receptors themselves and thus causing upregulation of of sebum and whatnot. So it's basically a much less invasive method of treating acne. Now obviously you've probably heard of RU5841, another anti-androgen. Um RU5841 tends to work better on hair from my experience. It's kind of a little bit inflammatory when applied to your actual skin. Uh CB0301 seems to be a lot better when actually you mix half a milliliter in with lotion or something and then apply it to your face. It's not irritating at all. Uh it doesn't smell like anything. It it's typically very minimally invasive. Um and along with that, it tends to do great for actually treating acne from pure DHT derivatives.

[00:04:40]Um so if you're getting acne from Primo or Master, I would a thousand% give CB0301 a try. Um considering oral fava inhibitors like finasteride and dutastasteride aren't really going to do anything for it. So, for that reason, considering it is basically the go-to for treating uh DHT derivative acne, I'm putting CB0301 um in S tier. Um I have used RU5841 on my face before when I run out of CB. It's just not great. Uh it's probably as effective, I would say, but it's just kind of more uncomfortable. Um if you have like topud topaludide on hand, um that one is a little bit more mild compared to CB0301. Um, so you could also give that one a try if you can't get CB.

[00:05:23]Um, okay. Ketoconazole shampoo. Now, ketoconazole shampoo, um, one or 2% is basically a topical anti-androgen. Um, this tends to work very well if you have back acne. Um, you can apply basically this shampoo onto like a scrub brush and then rub it on your back in the shower and that tends to work very well for back and chest acne specifically. Um, obviously you use it in your hair as well to prevent uh, you know, DHT and DHT related um, androgenic alopecia, but um, when applied to your back and your chest via a scrub in the shower uh, two to three times a week, it does tend to do very very well with chest and back acne. And sort of tying in with that, changing your sheets extremely crucial if you're getting back and chest acne.

[00:06:11]Um, changing your sheets to prevent buildup of just [ __ ] gunk on them will absolutely save you a lifetime of misery. Um, so I'm putting I'm putting shampoo um in a tier just because I think it's one of the best treatments overall for back and chest acne besides oral retinoids. Daily injections. Um, this is going S tier. If you're pinning [ __ ] twice a week of testinanthate, yeah, obviously you're going to run into hormonal issues, gigantic spikes in your estrogen and crashes, uh, leading to obviously hormonal imbalances and thus you will likely get some amount of acne or at least acne flare-ups. So, if you're not before you use any of these things, if you're not already injecting daily, injecting daily um, and just overall good hygiene when it comes to changing your sheets, um, and not having a sweaty face after the gym and sitting around all day, etc., etc., All those things are very very crucial.

[00:07:04]Do all those things before you actually start implementing pharmaceuticals. Um doxycycline. So this is an antibiotic.

[00:07:11]Um you'll typically see this one prescribed or sometimes ampein. Now these antibiotics work. The problem is they don't work that well. Um anyone who's ever been prescribed one of these before, if you eventually get unlucky enough to have um really these these suck for a wide variety of reasons. one, they can absolutely rape your gut. Um, so really, if you ask your dermatologist who's prescribing you doxycycline or aecylin, and you're like, "Yeah, is this going to be okay for my overall like gut microbiome health?" They'll probably lie to your face and tell you you'll be fine if you eat it with food. Complete [ __ ] [ __ ] Uh, these these things will destroy your gut microbiome. Um, I've had this firsthand. I don't think I laid a single solid turd while using 500 milligrams of ampillin twice a day.

[00:07:56]Along with that, if you developed if you develop antibioticresistant bacteria, uh it basically does nothing. So, it really only works for uh particularly bacterial related acne. Um and if you get unfortunate enough that the basically the acne [ __ ] evolve, um congratulations, you're actually fried.

[00:08:15]So, not that efficacious as a treatment option in my opinion. Once you stop using it, the acne tends to come back.

[00:08:22]um just overall it's kind of a first line of defense for like [ __ ] dermatologists. Um but it doesn't really work that well.

[00:08:30]Azelic acne. So this is another uh topical 5 AR inhibitor in skin that works very well. There's actually studies to show um that not only is it a good topical um anti-androgen. I I believe it's nearly up to 90% um of the type one enzyme um that's blocked. Um, and there are some studies to show that it does work fairly well for reducing acne, but I think there's better options like using a topical anti-androgen um before you use dazzle acne, but it's overall fairly solid. So, honestly, I'll put it in a tier.

[00:09:07]Dude, this dog in the background is like I think humping another pillow.

[00:09:11]Um, see what we got here. Um so this is a synthetic synthetic I think third generation topical retinoid. So as trett is basically just the topical retinoid form of of like vitamin A. Um this tends to be a bit better for white heads. Um while adapalen tends to be a little bit better overall I would say um for like inflammation um just because it's it's more specific on the receptors it acts on and along with that it tends to be uh less inflammatory in and of itself. Uh it's kind of just like a more refined version of tread. So, if you're suffering from sort of uh sort of inflammation based acne on your face as opposed to like white heads, um I I would say adapalene probably is better.

[00:10:02]Along with that, adapine doesn't tend to dry out your skin as much. Um tre is is pretty brutal on the on the skin and the lips. So I would say adopene overall is I would say adapalene is probably B and I'd probably put topical tre in C just because both both of these kind of lack in the area that if you have any sort of like like nodular um or like cystic acne re really neither of these topicals are going to help that much. They're kind of just better at individual things and along with that adapeline is just kind of more selective. Um it tends to have a better side effect profile from like a drying perspective. Um, what is this?

[00:10:39]Oh, topical estriol cream. Basically, topical vagina cream. Um, it does what it sounds like. Acts on the estrogen receptor A and estrogen receptor B. Um, it's anti-inflammatory. Will decrease sebum production. Uh, will decrease the actual local concentrations of the 5 AR enzyme in your skin. So, you get less conversion of testosterone into DHT at the level of your skin. Overall, good compound. Fairly niche. don't see a lot of people use this one um because of fears of it going systemic, but it does give you an extremely youthful looking appearance in your skin. Um so I would say honestly topical estradiol cream is is probably a tier. Um a heavily slept on one, but if it goes systemic obviously you'll have to adjust your hormonal profile. So I wouldn't really ever consider this as a natural, but this isn't for natural. It's on cycle.

[00:11:26]So, obviously if you're printing gigantic amounts of DHT derivatives, you probably don't really care about a little bit of topical estrogen going systemic. Um, but you know, that's that.

[00:11:35]Uh, Accutane, must I even say anymore?

[00:11:37]Literally the end all beall. It's going to upregulate collagen. It's going to literally nuke your acne. Doesn't matter if it's [ __ ] inflammation based.

[00:11:43]Doesn't matter if it's if it's [ __ ] uh nodular, if it's cystic acne, it doesn't matter. Seven production shrunk.

[00:11:50]Whiteheads gone. It's literally the end all be all of acne treatment. Um, obviously it does come with side effects, I think this drug technically is a blackbox warning. Um, and look, if you're going to sit here and [ __ ] throw stones from the comments about me putting Accutane in S tier, um, when there's like suicide warnings for it, there that [ __ ] is that [ __ ] is [ __ ] Look, if you there on the very few studies that are done evaluating Accutane treatment and mental health, these scores are better following Accutane usage. probably because if you suffer from extremely bad cystic acne, having your acne fixed by a pill you take once a day probably improves your quality of life. So, the depression thing completely [ __ ] overblown. Does it impact your cholesterol? Does it impact sometimes your LDL, your APOB?

[00:12:32]Yes. Do I think anyone should be running realistically more than 20 to 40 milligrams of Accutane daily? Also, no.

[00:12:38]I think the dermatologists that put people on 80 milligrams of Accutane are smoking crack out of their anus. So, with that being said, 20 milligrams of Accutane daily, you carry around a stick of Vaseline, and you stay properly hydrated, you're going to have literally zero side effects. Photosensitivity isn't a concern. Unlikely to move your your any of your [ __ ] blood work parameters at all. And if it does, if somehow your a and alt or gamma gt by some [ __ ] like godscent like miracle, not even godscent miracle, some like satan miracle um are elevated. Then at that point, you just intervene with tka or knack or glutathione or literally [ __ ] like any over-the-counter liver supplement like [ __ ] milk thistle would work. Milk thistle actually sucks for a variety of reasons and then some thyroid implications. But Accutane side effect profile is extremely easily manageable at 20 to 40 milligrams daily.

[00:13:30]Along with that, it is basically the end all beall. I've been on Accutane since October. I had acne for a [ __ ] long ass time. Um, I tried literally every every single [ __ ] option on this list. Only thing that ever fixed my acne. Um, really was Accutane. CV0301 along with that is great. like like great if you have no acne than a DHT derivative, it's awesome. Finasteride, awesome. Um, but Accutane alone, I I did more than the other two things combined.

[00:13:58]Along with that, zero impact on my blood work at all. Um, at 20 milligrams daily, I'll probably be running this stuff for the next couple years. It's just absolutely goated. Having no acne is goated. Accutane is the end all beall.

[00:14:12]It's going to improve your dermal collagen balance by downregulating um MMP9 and 13 which break down collagen in your skin. It's going to basically increase the balance of your collagen, improving your skin complexion and overall just making you look better.

[00:14:25]Accutane's S tier. If you argue with me in the comments, I'm going to tell you to rope max. Um this is the overall tier list. I actually think this is a fairly goated tier list. Um, really with these four right here, finasteride, CB000301, daily injections, and Accutane, you could manage really any acne symptom under the under the sun. With that being said, uh, this is the official list.

[00:14:47]Argue with me in the comments. Um, if you've got some [ __ ] to say, blow me.

[00:14:53]That's that.