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

It sounds like you're dealing with a frustrating situation! When drugstore products aren't cutting it for adult acne, it's often a sign that you need a more targeted approach, possibly involving prescription-strength ingredients or professional guidance. Here's what you should do, broken down into steps with specific recommendations:

1. Schedule an Appointment with a Dermatologist:

This is the most crucial step. A dermatologist can properly diagnose the type and severity of your acne and create a personalized treatment plan. They have access to prescription medications and advanced treatments that are far more potent than anything available over-the-counter.

• Why: Adult acne can be influenced by hormones, stress, lifestyle, and underlying skin conditions. A dermatologist can pinpoint the cause and recommend the most effective solutions.
• What to expect: They will likely examine your skin, ask about your medical history, current skincare routine, and any medications you're taking. They might also ask about your diet and stress levels.

2. Consider Prescription Topical Treatments:

Your dermatologist will likely prescribe topical treatments that contain higher concentrations of active ingredients than drugstore options.

• Examples of common prescription topicals:
  • Tretinoin (Retin-A, Atralin, etc.): A powerful retinoid that exfoliates, unclogs pores, and can help with cell turnover. It's a gold standard for acne treatment.
  • Adapalene (Differin 0.3% - now available OTC, but prescription versions are stronger): Another retinoid that's very effective.
  • Clindamycin or Erythromycin: Antibiotics that kill acne-causing bacteria and reduce inflammation. Often combined with other ingredients.
  • Benzoyl Peroxide (prescription strengths): A potent antibacterial agent that also helps unclog pores. Available in higher percentages by prescription.
  • Azelaic Acid (prescription strengths): Helps reduce inflammation and kill bacteria, and can also help with post-acne marks.

3. Explore Oral Medications:

For moderate to severe acne, or acne that doesn't respond to topicals, your dermatologist might recommend oral medications.

• Examples of common oral medications:
  • Antibiotics (e.g., Doxycycline, Minocycline): These reduce bacteria and inflammation. They are usually prescribed for a limited time.
  • Hormonal Therapies (e.g., certain birth control pills, Spironolactone): These are very effective for women whose acne is linked to hormonal fluctuations. Spironolactone is particularly good for jawline and chin acne.
  • Isotretinoin (formerly Accutane): A very powerful oral retinoid reserved for severe, cystic, or treatment-resistant acne. It has potential side effects and requires close monitoring by a dermatologist.

4. Professional Procedures:

In addition to medications, your dermatologist can offer in-office procedures.

• Examples of professional procedures:
  • Chemical Peels: Use stronger acids than at-home peels to exfoliate the skin, unclog pores, and improve texture.
  • Cortisone Injections: For large, painful, inflamed cysts, a dermatologist can inject a corticosteroid directly into the lesion to quickly reduce inflammation and size.
  • Comedone Extraction: If you have stubborn blackheads and whiteheads, a dermatologist or trained aesthetician can safely extract them.

5. Consider Your Lifestyle and Diet (Under Professional Guidance):

While not a substitute for medical treatment, certain lifestyle factors can play a role. Discuss these with your dermatologist.

• Diet: Some people find that certain foods can trigger their acne (e.g., dairy, high-glycemic index foods). A dermatologist or a registered dietitian can help you identify potential triggers.
• Stress Management: High stress levels can exacerbate acne. Finding healthy ways to manage stress (e.g., exercise, mindfulness, yoga) can be beneficial.
• Skincare Routine: Even with prescription treatments, a gentle and consistent skincare routine is essential. Your dermatologist can help you build one that complements your prescription.

Brands and Services to Look For:

• Dermatology Clinics: Search for board-certified dermatologists in your area. Websites like the American Academy of Dermatology (AAD) can help you find qualified professionals.
• Prescription Skincare Brands (often prescribed by dermatologists):
  • Galderma: Produces prescription retinoids and other acne medications.
  • Bausch Health (formerly Valeant): Offers a range of prescription acne treatments.
  • La Roche-Posay and CeraVe (Dermatologist-Recommended): While primarily drugstore brands, many of their products are recommended by dermatologists as gentle, effective complementary products for acne-prone skin, especially their cleansers and moisturizers. Look for fragrance-free and non-comedogenic options.

Key Takeaway:

Don't get discouraged! Adult acne is common, and there are many effective treatments available beyond what you can find at the drugstore. The best course of action is to seek professional help from a dermatologist. They will be your best ally in achieving clearer skin.