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

Sorry it’s been stubborn — adult acne often needs more than drugstore fixes. Practical next steps, what to expect, and specific options:

1. See a board‑certified dermatologist (or a reputable telederm)

• Why: they can examine your skin, rule out other causes, prescribe stronger meds, and monitor side effects.
• Telederm options if in‑person access/cost is a problem: Curology, Apostrophe (or your country’s equivalent). These services can prescribe tretinoin/adapalene combos, topical antibiotics, or azelaic acid.

1. Prescription treatments commonly used (ask your dermatologist about these)

• Topical retinoids — speed cell turnover, prevent new comedones: tretinoin (Retin‑A), tazarotene (Tazorac) or adapalene prescription strength (Differin 0.3% by Rx). Expect 8–12 weeks to see improvement.
• Combination topical products — reduce inflammation and bacteria: Epiduo (adapalene + benzoyl peroxide) or Duac/Ziana (clindamycin + benzoyl peroxide).
• Topical dapsone — Aczone (good for inflammatory lesions and some adult acne).
• Oral antibiotics (short term) — doxycycline (Vibramycin) or minocycline (Minocin) for moderate inflammatory acne; often used together with benzoyl peroxide to limit resistance.
• Hormonal therapy (for women) — combined oral contraceptives with proven benefit (Yaz, Ortho Tri‑Cyclen, Estrostep) or spironolactone (Aldactone, off‑label) to reduce androgen‑driven acne. Effective for many adult females.
• Oral isotretinoin (Accutane and other brands: Absorica, Claravis) — for severe, nodulocystic, or treatment‑resistant acne. Very effective but requires strict pregnancy prevention and monitoring (iPLEDGE program in the U.S.), and blood tests for liver/lipids.

1. In‑office procedures (for persistent acne or scarring)

• Chemical peels (salicylic/glycolic), light/laser treatments (photodynamic therapy, fractional lasers), extractions, and microneedling for scarring. Ask your dermatologist which is appropriate.

1. Skincare routine to use alongside prescriptions

• Gentle, pH‑balanced cleanser (twice daily).
• Use a topical benzoyl peroxide product (2.5–5%) once daily to reduce bacteria (can be drying). Brands: Neutrogena On‑the‑Spot, PanOxyl.
• Continue/adopt a retinoid at night as prescribed. Differin gel (OTC 0.1%) is a good starter if you haven’t tried it yet.
• Non‑comedogenic moisturizer and broad‑spectrum SPF 30+ daily.
• Avoid aggressive scrubs, picking/popping, and heavy oil‑based makeup.

1. Practical notes, timing, and safety

• Expect 8–12 weeks to see meaningful change with topicals; oral meds may act faster for inflammatory acne.
• Antibiotics should be short‑term (usually ≤3 months) to prevent resistance.
• Spironolactone: effective for many women but requires discussion about contraception and monitoring (kidney function/potassium in high‑risk patients).
• Isotretinoin is teratogenic — strict contraception and monthly pregnancy tests are mandatory. It also requires liver/lipid monitoring.
• Keep photos to track progress and bring them to appointments.

1. What you can do next week

• Book a dermatology visit or sign up for a telederm service (Curology/Apostrophe).
• Stop using potentially irritating layering of many OTC actives (exfoliating acids + benzoyl peroxide + retinoid all at once) until you get a plan.
• Start a gentle routine, use sunscreen, and document your skin with photos.

If you want, tell me: your age, sex, type of lesions (whiteheads/blackheads vs red pustules or deep nodules), any current prescriptions or birth control, and whether you can see an in‑person dermatologist — I can suggest a likely first‑line plan and questions to ask.