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

If drugstore products haven’t helped, see a clinician — adult acne often needs prescription medicines or in‑office treatments. Steps and options to discuss with a board‑certified dermatologist (or a reputable telederm):

1. See a dermatologist (or telederm)

• Why: they can identify acne type and underlying causes (hormonal, inflammatory, medication‑related), look for scarring, and prescribe appropriate treatments. Use the American Academy of Dermatology website to find local board‑certified dermatologists, or telederm services like Curology or Apostrophe for prescription plans if you prefer remote care.

1. Prescription topical options

• Retinoids (strengthen skin cell turnover): tretinoin (brand: Retin‑A), tazarotene (Tazorac), or adapalene (Differin — OTC 0.1% or prescription 0.3%). Prescription retinoids are often more effective than OTC.
• Combination topicals: Epiduo (adapalene + benzoyl peroxide) or Duac (clindamycin + benzoyl peroxide) to reduce both comedones and bacteria.

1. Oral medicines (for more persistent or inflammatory acne)

• Oral antibiotics for short courses (doxycycline, minocycline/Minocin) — used briefly to calm inflammation.
• Hormonal options for adult women: combined oral contraceptives approved for acne (Ortho Tri‑Cyclen, Yaz, Estrostep) or spironolactone (Aldactone) which blocks androgen effects — very effective for hormonal acne but used under physician supervision.
• Isotretinoin for severe or treatment‑resistant nodulocystic acne (brand names: Accutane, Absorica, Amnesteem). Highly effective but requires strict monitoring and pregnancy prevention (iPLEDGE in the U.S.) because of teratogenicity.

1. In‑office procedures (speed results or treat scarring)

• Chemical peels (salicylic or glycolic acids), Blue/Red light or photodynamic therapy, laser resurfacing (Fraxel for scarring), or microneedling (SkinPen). These are done by dermatologists or licensed medical aesthetic clinics.

1. Basic daily skincare to support treatment

• Gentle cleanser (CeraVe Foaming or Cetaphil), non‑comedogenic moisturizer (CeraVe PM), sunscreen (EltaMD UV Clear is popular for acne‑prone skin). Avoid harsh scrubs, picking, and pore‑clogging oils/comedogenic makeup (look for “non‑comedogenic” or “oil free” — brands: La Roche‑Posay Effaclar line, Neutrogena).

1. When to check for underlying causes

• If you have irregular periods, new facial/body hair, sudden severe acne, or adult onset acne after age 25–30, ask your doctor about hormonal testing (PCOS workup).

How to choose a provider

• Prefer a board‑certified dermatologist for medical acne care. If you want telemedicine, Curology and Apostrophe provide personalized prescriptions and follow‑up. For complex cases or isotretinoin, see an in‑person dermatologist.

If you’d like, tell me: your age, sex, how long you’ve had acne, type (whiteheads, blackheads, red bumps, deep nodules), and any treatments you already tried — I can suggest specific next steps to discuss with a doctor.