I have adult acne that drugstore products cannot fix. What should I do?

Sorry you’re dealing with stubborn acne — that’s frustrating. If drugstore products haven’t helped, here’s a clear plan and what to expect next.

1. See a dermatologist (best first step)

• Why: a board‑certified dermatologist can diagnose your acne type, check for scarring, screen for underlying causes (like hormonal acne/PCOS), and prescribe stronger, evidence‑based treatments.
• If you can’t see someone in person quickly, consider telederm services such as Curology or Apostrophe — they’ll review photos and can prescribe custom topical combos (retinoid + azelaic or antibiotic) or oral meds.

1. Prescription treatments your dermatologist may recommend (with brand examples)

• Topical retinoids: tretinoin (Retin‑A, generic) or tazarotene (Tazorac). More effective than most OTC retinoids for moderating pores and preventing new lesions.
• Azelaic acid: Finacea (prescription 15% gel) — good for inflammatory lesions and post‑inflammatory hyperpigmentation; The Ordinary Azelaic Acid 10% is a cosmetic alternative.
• Topical antibiotics/combination products: clindamycin + benzoyl peroxide (Benzaclin) — useful short term with other agents.
• Oral antibiotics: doxycycline or minocycline — for moderate inflammatory acne while topicals take effect.
• Hormonal therapy (if indicated): combined oral contraceptives proven for acne (Yaz, Ortho Tri‑Cyclen) or spironolactone (generic Aldactone) for women — valuable when acne flares with menstrual cycle or signs of hormonal imbalance.
• Oral isotretinoin (Accutane, Amnesteem, Claravis): for severe or treatment‑resistant acne. Very effective but requires strict monitoring and pregnancy prevention (iPLEDGE in the U.S.) and lab follow‑up.

1. In‑office procedures (if recommended)

• Cortisone injection for large painful nodules (fast relief).
• Chemical peels (salicylic or glycolic), laser/light therapies, or microneedling for persistent inflammation, scarring, or pigmentation — ask a dermatologist about efficacy and downtime.

1. Practical daily skin care (supportive, not a replacement for Rx)

• Gentle cleanser twice daily (CeraVe Hydrating or Cetaphil); avoid scrubs that irritate.
• Non‑comedogenic moisturizer: CeraVe PM, La Roche‑Posay Toleriane, Vanicream.
• Sunscreen daily: EltaMD UV Clear (good for acne‑prone/rosacea skin).
• Targeted OTC: benzoyl peroxide (PanOxyl), salicylic acid exfoliants (Paula’s Choice 2% BHA) or Differin (adapalene) if you haven’t tried it — but stop or switch if you already did with no benefit.

1. Consider evaluation for hormonal causes

• If you have irregular periods, excess facial/body hair, sudden worsening in adulthood, or other symptoms, ask your provider about hormone testing or referral to endocrinology/gynecology.

1. What to expect timing-wise and safety notes

• Topical retinoids/azelaic acid: 8–12 weeks to see meaningful improvement.
• Oral antibiotics or hormonal meds: often 2–3 months to judge benefit.
• Isotretinoin: dramatic improvement for many, but requires strict pregnancy prevention and monitoring.

1. Lifestyle tips that may help

• Avoid picking/popping lesions (prevents scarring).
• Low‑glycemic diet and cutting back on dairy can help some people.
• Keep hair and hats away from the face; choose non‑comedogenic makeup (Neutrogena, La Roche‑Posay).
• Manage stress and sleep — both affect skin inflammation.

If you’d like, tell me: how long have you had acne, what treatments you’ve already tried, whether you’re on hormonal birth control, and whether you have irregular periods or excess hair — I can suggest more specific next steps.