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

Sorry you’re dealing with stubborn acne — adult acne is common and often needs prescription care. Here’s a practical plan and specific brands/services to consider.

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

• Why: They can diagnose type (hormonal, inflammatory, cystic), look for scarring, and prescribe effective medications.
• In-person: find a board-certified dermatologist via the American Academy of Dermatology site or Zocdoc.
• Telederm options that prescribe and ship meds: Curology (personalized topical formulas), Apostrophe (dermatologist-reviewed prescriptions), and Hims/Hers (good for hormonal acne and offers spironolactone). These are convenient if you prefer virtual visits.

1. Prescription treatments your dermatologist may recommend

• Topical retinoids: tretinoin (brand names Retin-A, Altreno) or prescription-strength adapalene — normalize skin turnover and prevent new comedones.
• Combo topical therapies: clindamycin + benzoyl peroxide or tretinoin/benzoyl combos — reduce bacteria and inflammation.
• Oral antibiotics (short term): doxycycline or minocycline for inflammatory flares.
• Hormonal options (for people with menstrual-linked or lower-face acne): combined oral contraceptives like Yaz, Ortho Tri-Cyclen, or Estrostep; or spironolactone (commonly used off-label).
• Isotretinoin (Accutane) for severe/recalcitrant cystic acne — very effective but requires specialist supervision and strict pregnancy prevention.

1. Fix your daily routine (use gentle, non-comedogenic products)

• Cleanser: CeraVe Foaming Facial Cleanser or La Roche-Posay Effaclar — gentle and won’t strip skin.
• Benzoyl peroxide (short-term spot/combination use): PanOxyl or Neutrogena On-the-Spot.
• Moisturizer: CeraVe PM, Vanicream, or La Roche-Posay Toleriane — non-comedogenic and helps with retinoid irritation.
• Sunscreen: EltaMD UV Clear (favored for acne-prone, contains niacinamide) or La Roche-Posay Anthelios.
• Avoid over-exfoliating, heavy oils/occlusive makeup, and picking.

1. Lifestyle and monitoring

• Consider lowering high-glycemic carbs and reducing skim milk if you notice links — evidence is modest but sometimes helpful.
• Track when breakouts happen (cycle, stress, products) and take photos to show your clinician.
• If you’re a woman of childbearing potential and considering spironolactone or isotretinoin, discuss contraception and required testing.

1. When to seek urgent care

• See a dermatologist sooner if you have painful cysts, rapidly spreading lesions, scarring, or major emotional distress.

Next steps I suggest: book a dermatologist appointment (or start a telederm consult with Curology or Apostrophe), stop any harsh scrubs, and switch to a gentle cleanser + non-comedogenic moisturizer/sunscreen. Bring a list of current products and photos of your acne to the visit.

If you want, tell me your sex, where on your face/body the acne appears, and what prescriptions you’ve already tried — I can suggest likely next options to bring up with a clinician.