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

You’re not alone — adult acne that doesn’t respond to drugstore products is common and usually needs prescription treatment or in‑office procedures. Here’s a clear plan and what to expect.

1. See a dermatologist (or start telederm)

• Why: a dermatologist will classify your acne (comedo, inflammatory, cystic), rule out medical causes, and prescribe targeted therapy.
• Telederm options if you want faster access: Curology, Apostrophe, or Hims/Hers (these services can prescribe topical and some oral meds remotely depending on where you live).

1. Prescription treatments the dermatologist may recommend

• Topical retinoids: tretinoin (Retin‑A), tazarotene (Tazorac) or adapalene (Differin) — reduce clogged pores and normalize skin cell turnover. Differin 0.1% is OTC in some places, but stronger Rx versions work better for stubborn adult acne.
• Topical combos: prescription benzoyl peroxide + topical antibiotic or retinoid to reduce inflammation and bacteria.
• Oral antibiotics (short term): doxycycline or minocycline for inflammatory acne (used for weeks–months only to limit resistance).
• Hormonal therapy (for people with ovaries): combined oral contraceptives approved for acne (e.g., Ortho Tri‑Cyclen, Estrostep, Yaz) or spironolactone (Aldactone) — very effective for many adult women with hormonal component.
• Isotretinoin (Accutane / Absorica / Amnesteem): for severe cystic or treatment‑resistant acne — highly effective but requires close monitoring and pregnancy prevention.

1. In‑office procedures

• Chemical peels (salicylic, glycolic), steroid injections for painful nodules, light/laser therapies, or extraction of comedones. For scarring, lasers or microneedling can help later.

1. Gentle daily skincare (avoid making things worse)

• Cleanser: gentle, non‑foaming or mild foaming cleanser — CeraVe Hydrating or Cetaphil gentle cleanser.
• Targeted actives: benzoyl peroxide (2.5–5%) for breakouts; salicylic acid (0.5–2%) for clogged pores. Use cautiously with retinoids to avoid irritation.
• Moisturizer: non‑comedogenic options like CeraVe PM, Vanicream, or Neutrogena Hydro Boost.
• Sunscreen: EltaMD UV Clear (often recommended for acne‑prone, rosacea or retinol users).
• Don’t over‑exfoliate, don’t pick or pop, and introduce active ingredients slowly.

1. Tests & monitoring

• If a hormonal cause is suspected, your derm may order androgen tests or refer to an endocrinologist.
• If prescribed isotretinoin: pregnancy tests, liver enzymes and lipid monitoring are required. Spironolactone may require periodic labs depending on your health.

1. Timeline & expectations

• Topicals: may take 8–12 weeks to show improvement.
• Hormonal therapy/spironolactone: often 3 months or more for full effect.
• Isotretinoin: often clears acne after a full course (4–6 months).

What I recommend you do next

• Book an appointment with a board‑certified dermatologist. If you want quicker access, try Curology or Apostrophe (availability depends on country).
• If you’d like, tell me: your age, sex, type of acne (blackheads, whiteheads, red bumps, painful cysts), any medicines you’ve tried (prescription names if any), and whether your acne flares with your cycle — I can suggest specific next steps or a sample questions list to bring to the dermatologist.

If you want, I can also help you pick a gentle routine to use while you arrange a dermatology visit.