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

Sorry it’s been so frustrating — adult acne often needs prescription care or in‑office treatments. Here’s a practical plan and the most likely next steps.

1. See (or tele‑visit) a dermatologist

• Why: they can evaluate type/causes of your acne (hormonal versus inflammatory versus nodulocystic), prescribe stronger/topical or oral meds, and offer procedures to prevent scarring.
• If you want telemedicine: Curology and Apostrophe (both provide remote dermatologist-prescribed topical regimens including tretinoin/azelaic/clindamycin) and Ro (Roman) also offer online dermatology visits. For in‑person, use the American Academy of Dermatology “Find a Dermatologist” to locate a board‑certified dermatologist near you.

1. Prescription treatments commonly used for adult acne

• Prescription topical retinoids: tretinoin (Retin‑A), tazarotene (Tazorac), or prescription‑strength adapalene. These normalize skin cell turnover and help both inflammatory and comedonal acne.
• Combination topicals: topical retinoid + benzoyl peroxide or topical antibiotics/benzoyl peroxide (to reduce resistance).
• Azelaic acid (Finacea) — good if you have sensitive skin or post‑inflammatory hyperpigmentation.
• Oral antibiotics: doxycycline or minocycline for moderate inflammatory acne (short course while topical therapy takes effect).
• Hormonal treatments (for people who can get pregnant and whose acne is hormonally driven): combined oral contraceptives approved for acne (e.g., Ortho Tri‑Cyclen, Yaz) or spironolactone (50–200 mg/day) — both can be very effective for adult female acne.
• Isotretinoin: for severe/nodulocystic acne or acne causing scarring; highly effective but requires specialist monitoring and pregnancy prevention programs (iPLEDGE in the U.S.).

1. In‑office procedures that help faster or treat scarring

• Corticosteroid injection for painful cysts, chemical peels (salicylic/glycolic), microneedling or lasers (fractional laser, PDL) for acne scarring, and light/laser therapies for inflammatory acne. Your derm will advise based on severity.

1. What to do now (practical skin care)

• Stop aggressive scrubs and “layering” lots of OTC actives — that can irritate and worsen acne.
• Gentle cleanser: CeraVe Foaming or Cetaphil Gentle Cleanser.
• Non‑comedogenic moisturizer: CeraVe PM, Vanicream, or Neutrogena Hydro Boost.
• Sunscreen daily: EltaMD UV Clear is often recommended for acne‑prone skin.
• If you haven’t tried an OTC retinoid, Differin (adapalene 0.1%) can help, but prescription retinoids are generally stronger.
• Don’t pick or pop lesions — that increases scarring risk.

1. How long to expect

• Most medical treatments take 8–12 weeks to show clear improvement. Be patient and keep follow‑up with your provider to adjust therapy.

1. When to see a dermatologist urgently

• Nodules/cysts that are painful, rapidly spreading inflammation, new or active scarring, or if acne is causing depression/serious emotional distress.

If you’d like, tell me:

• your sex/age, whether you’re pregnant or breastfeeding, what prescription treatments you’ve already tried, and whether you’re developing scars — I can suggest a likely next step and which treatment to ask a dermatologist about.