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

Short answer: see a board‑certified dermatologist (or a reputable telederm) — adult acne often needs prescription medicine or in‑office procedures that drugstore products can’t provide.

What your dermatologist may offer

• Prescription topicals: tretinoin (Retin‑A, Altreno), prescription adapalene, topical antibiotics or combination gels, prescription azelaic acid (Finacea). These are stronger and work better for many adults.
• Oral medications: antibiotics short‑term, combined oral contraceptives approved for acne (e.g., Ortho Tri‑Cyclen, Yaz) for hormonally driven acne in people who can take OCPs, or spironolactone (generic Aldactone) for adult women with hormonal acne.
• Isotretinoin (Accutane and other brand/generic formulations) for severe or scarring acne — very effective but requires monitoring and pregnancy‑prevention programs.
• Office procedures: cortisone injections for painful cysts, chemical peels, laser/light therapies, microneedling, extractions — useful when topical/oral meds aren’t enough.

Telederm and in‑person options (brands/services)

• Curology — personalized prescription creams (tretinoin, azelaic acid, topical antibiotics) via telemedicine; good for ongoing management.
• Apostrophe — online dermatologist care and compounded prescription treatments.
• Hers — telederm services for women that can prescribe spironolactone, tretinoin, etc.
• Zocdoc or the American Academy of Dermatology (aad.org) — to find a local board‑certified dermatologist for in‑office evaluation and procedures.

Supportive skincare (use while you wait / alongside prescriptions)

• Gentle cleansers: CeraVe Foaming or Hydrating Cleanser, La Roche‑Posay Toleriane.
• Salicylic acid exfoliant: Paula’s Choice 2% BHA (well tolerated and effective).
• Moisturizers: CeraVe PM, La Roche‑Posay Toleriane Ultra (non‑comedogenic).
• Sunscreen: EltaMD UV Clear (favored for acne‑prone skin), La Roche‑Posay Anthelios.
• Spot/cleansing benzoyl peroxide: PanOxyl (use carefully — can be drying/bleach fabrics).

How to prepare for a dermatologist visit

• Bring a list of all current skincare products and medications, photos showing your acne over time, menstrual history if relevant, and a brief history of what’s been tried.
• Mention scarring, painful nodules, or rapid worsening — those need earlier, often urgent treatment.

What to watch out for

• If you’re a woman with acne linked to cycles, ask about hormonal treatment (spironolactone or specific OCPs).
• Isotretinoin works for stubborn cases but has important side effects and pregnancy‑prevention rules.
• Avoid picking/popping lesions (scarring risk) and don’t layer many active OTC products at once — that can worsen irritation.

If you want, I can:

• Help you pick one or two telederm services based on cost/insurance.
• Suggest a gentle starter routine while you arrange a dermatology visit.
• Tell you what questions to ask a dermatologist. Which would you like?