Mandelic acid has been widely studied for the treatment of skin blemishes and skin conditions such as acne. It is indeed an excellent option for acne-prone skin, as it treats the four main causes of acne. It "controls" sebum secretion, inhibits bacterial growth, prevents pore clogging by increasing the skin's natural exfoliation process and reduces inflammation. In addition, compared to other AHAs and BHAs, it is less likely to cause skin irritation or post-inflammatory hyperpigmentation.
Anti-inflammatory, anti-bacterial, exfoliating... mandelic acid combines all the properties to act on pimples. A 2020 study even showed that a mandelic acid peel (45%) is just as effective as a salicylic acid peel (30%) in treating mild to moderate facial acne, while causing less irritation and side effects. Indeed, in Indian acne patients, the use of 45% mandelic acid peels once every two weeks for 12 weeks resulted in significant resolution of comedones, papules and pustules.
Another study also suggests the efficacy of 10% mandelic acid peels (+ 20% salicylic acid) in reducing non-inflamed and inflamed lesions when applied every two weeks for three months. In addition, they are also useful in nodular and cystic acne, and acne scars. Other research suggests that 5% mandelic acid is also just as effective in improving acne papules and pustules as 10% mandelic acid over an 8-week period. So you don't need a high concentration to get results.
How does mandelic acid work to improve acne? Still unknown, the exact mechanism of effect could be due to the modification of keratinization, and the anti-inflammatory and anti-bacterial activity of mandelic acid could also play a role in the improvement of acne. When you add up all of these benefits, mandelic acid could notably contribute to the prevention of pimples.