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

Sorry you’re dealing with persistent acne — that’s frustrating. If drugstore products haven’t helped, the best next step is to see a clinician (dermatologist or a reputable telederm) so you can get prescription treatment and a tailored plan. Below is a concise, practical plan and specific names to ask about.

1. See a dermatologist (in-person or telederm)

• Why: they can prescribe stronger medications, assess for underlying causes (like hormonal acne/PCOS), and offer in‑office treatments.
• Services to consider: Curology, Hims/Hers (telederm options that prescribe customized topicals or oral meds), or book an in‑person derm via Zocdoc or your local dermatologist. For persistent or severe cystic acne, an in‑person derm is preferred.

1. Prescription medication options your dermatologist may recommend

• Topical retinoid (often the cornerstone): tretinoin (Retin-A), prescription adapalene (higher strength than OTC Differin), or tazarotene. Retinoids normalize skin cell turnover and prevent new comedones.
• Topical combos: clindamycin + benzoyl peroxide (e.g., Benzaclin-style Rx), or topical dapsone (Aczone 7.5% gel) for inflammatory acne.
• Azelaic acid (Finacea 15% gel or Azelex 20% cream) for inflammation, pigmentation, and mild comedonal acne.
• Oral antibiotics (short term for inflammatory/pustular acne): doxycycline or minocycline to reduce bacteria/inflammation.
• Hormonal treatments for adult women: combined oral contraceptives approved for acne (e.g., Ortho Tri-Cyclen, Yaz) or spironolactone (Aldactone) — very effective for hormonal flare patterns. Discuss contraception and clot risk with your provider first.
• Isotretinoin (formerly Accutane; generic names like Claravis, Amnesteem): for severe, nodulocystic, or treatment‑resistant acne. Highly effective but requires strict monitoring (teratogenic — iPLEDGE program).

1. Things to expect and safety notes

• Most prescription treatments take 8–12 weeks to show marked improvement; retinoids can cause initial flares/dryness.
• Spironolactone and isotretinoin are contraindicated in pregnancy; discuss birth control and pregnancy testing as needed.
• Don’t combine tetracycline antibiotics with isotretinoin (risk of intracranial hypertension). Review all meds with your clinician.

1. Complementary skincare (gentle, non‑prescription items)

• Cleanser: CeraVe Foaming or Cetaphil Gentle Cleanser (twice daily).
• Moisturizer: CeraVe PM or Vanicream (non‑comedogenic).
• Sunscreen: EltaMD UV Clear (great for acne-prone skin) or La Roche-Posay Anthelios Melt-in Milk.
• Avoid harsh scrubs, alcohol toners, and over‑washing. If you wear makeup, choose non‑comedogenic products (Neutrogena SkinClearing, Clinique Acne Solutions).

1. In‑office procedures (ask your derm)

• Cortisone injections for painful nodules, light/laser therapies, chemical peels, or comedone extraction — useful adjuncts for faster results.

1. When to see a dermatologist urgently

• Large, painful cysts, rapidly worsening acne, scarring beginning, or significant impact on mood/quality of life.

If you want, tell me:

• your sex and age,
• where acne appears and what it looks like (whiteheads, blackheads, red bumps, cysts),
• any current/past prescription treatments, and I can suggest a likely next step and which medications you might specifically ask a dermatologist about.