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

You’re right to consider something beyond drugstore products — persistent adult acne often needs prescription medicine or procedures. Here’s a practical plan and options, with specific brands/services and why they’re useful.

1. See a dermatologist (best next step)

• Why: a dermatologist can examine your acne type, check for scarring, order labs if needed, and prescribe the right treatment (and procedures) rather than you guessing. Use the American Academy of Dermatology “Find a Dermatologist” tool, or book a tele-derm if you want faster access.
• Tele-derm services: Curology (custom prescription topical formulas including tretinoin/azelaic/clindamycin), Apostrophe (personalized treatment plans and prescriptions), and Hims/Hers (telederm + prescriptions). These are convenient and can get you prescription topicals quickly.

1. Prescription medication options (what dermatologists commonly try)

• Topical retinoids (very effective for most acne): tretinoin (Retin‑A, Altreno) or tazarotene (Tazorac). These normalize skin cell turnover and prevent new comedones; often combined with benzoyl peroxide or topical antibiotic.
• Topical dapsone (Aczone): helpful for inflammatory lesions, especially on darker skin where irritation/PIH is a concern.
• Oral antibiotics (short-term for inflammatory acne): doxycycline or minocycline — usually combined with a topical retinoid to avoid resistance.
• Hormonal treatments (for adult women with hormonal pattern acne): combined oral contraceptives with anti-androgenic progestins (examples: Yaz, Ortho Tri-Cyclen) or spironolactone (Aldactone) — spironolactone works well for many adult women.
• Isotretinoin for severe/nodulocystic or scarring acne (brand names include Accutane historically and current generics such as Claravis, Amnesteem, Absorica): often the most effective long-term cure but requires close monitoring, pregnancy prevention (iPLEDGE in the U.S.), and discussion of side effects.

1. In-office procedures that help when topicals/orals aren’t enough

• Intralesional steroid injections for painful nodules (fast relief).
• Chemical peels (salicylic/glycolic), light/laser therapies, microneedling or laser resurfacing for scarring.
• Your dermatologist can advise the right mix.

1. Practical everyday skin care (to support medical treatment)

• Gentle cleanser: CeraVe Hydrating Cleanser or Cetaphil Gentle Skin Cleanser.
• Non-comedogenic moisturizer: CeraVe PM Facial Moisturizing Lotion, La Roche-Posay Toleriane Double Repair.
• Sunscreen: EltaMD UV Clear (well-tolerated by acne-prone skin) or La Roche-Posay Anthelios.
• Avoid over-washing, harsh scrubs, and picking; introduce retinoids slowly to minimize irritation.

1. Lifestyle and other considerations

• Diet: evidence is limited, but lowering high‑glycemic foods and reducing dairy can help some people.
• Stress, sleep, and changing pillowcases/phone screens regularly can reduce flares.
• If you’re pregnant, breastfeeding, or planning pregnancy, many acne meds (especially isotretinoin and some hormonal treatments) are contraindicated — tell your provider.

1. Safety/monitoring

• Some meds require blood tests (e.g., isotretinoin, sometimes spironolactone) or contraception checks. Discuss side effects and monitoring with your provider.

Next steps I recommend

• Book a dermatology visit (in-person or via Curology/Apostrophe/Hims/Hers) for evaluation.
• If you want, tell me: your age, sex, how long you’ve had acne, what exactly you’ve tried, whether you’re on hormonal birth control or planning pregnancy — I can suggest more tailored next steps.

If you’d like, I can also draft questions to ask a dermatologist or help you pick between telederm services.