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

Sorry you’re dealing with stubborn acne — that’s common in adults and usually needs a step up from drugstore products. Practical next steps and options:

1. See a dermatologist (best first move)

• Why: they can diagnose the type/causes of your acne, check for hormonal issues (PCOS), order labs if needed, and prescribe faster/stronger treatments.
• If you can’t get in-person quickly, consider telederm services like Curology or Apostrophe (they prescribe custom topical combos and can follow you remotely).

1. Prescription topical treatments dermatologists commonly try

• Prescription-strength retinoids: tretinoin (Retin‑A, generic), tazarotene (Tazorac) or adapalene 0.3% — reduce clogged pores and prevent new lesions. Expect 8–12 weeks to see improvement.
• Topical combination products: clindamycin + benzoyl peroxide (BenzaClin) or benzoyl peroxide + adapalene — useful for inflammatory acne.
• Azelaic acid (Finacea 15% gel or Azelex) — good for inflammation and pigmentation; well tolerated.

1. Oral medications (for moderate-to-severe or inflammatory acne)

• Oral antibiotics (short-term): doxycycline or minocycline — reduce inflammation while topical/long-term therapy starts. Not ideal long-term (resistance risk).
• Hormonal options for adult women: combined oral contraceptives approved for acne (e.g., Ortho Tri-Cyclen, Yaz, Beyaz) or spironolactone (Aldactone) — often very effective when acne is hormonally driven.
• Isotretinoin (Accutane, Claravis, Absorica) — the most effective for severe cystic or treatment‑resistant acne but has serious teratogenic effects and requires strict monitoring (iPLEDGE program in the U.S.). Discuss risks thoroughly with a derm.

1. Adjunctive in‑home skincare (non-comedogenic, gentle)

• Cleanser: CeraVe Foaming Facial Cleanser or La Roche‑Posay Effaclar — gentle, non‑stripping.
• Exfoliant: salicylic acid product like Paula’s Choice 2% BHA Liquid or a 1–2% salicylic cleanser for blackheads/whiteheads.
• Moisturizer: CeraVe PM or Neutrogena Hydro Boost (non‑comedogenic) to reduce irritation from actives.
• Sunscreen: EltaMD UV Clear (formulated for acne-prone, often recommended by dermatologists).
• OTC azelaic acid: The Ordinary Azelaic Acid 10% can help pigmentation and mild inflammation.

1. Procedures your dermatologist might offer

• Chemical peels (salicylic/glycolic), extractions, light/laser therapies, or photodynamic therapy — helpful for certain cases or scarring prevention.

1. Practical tips & cautions

• Be patient: prescription topicals take 8–12 weeks; full effect may be months.
• Avoid over-washing or harsh scrubs — they worsen inflammation.
• Check ingredients: choose non‑comedogenic makeup/skincare.
• If you’re pregnant or planning pregnancy, many acne medications (isotretinoin, some retinoids, spironolactone) are contraindicated — tell the provider.
• Track photos to show progress; note patterns (cycle, stress, diet) to discuss with the doctor.

If you want, tell me: (a) your age, sex, what prescription or OTC products you’ve already tried, (b) whether you have cysts or mainly comedones/inflamed pimples, and (c) if you’re pregnant or on birth control — I can suggest a more specific next step or a likely treatment path.