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

You’re right to look for a next step — adult acne that doesn’t respond to drugstore products often needs prescription treatment or office procedures. Here’s a practical plan and specific options to discuss with a clinician.

1. See a dermatologist (in-person preferred; telederm is OK short-term)

• Why: a dermatologist will diagnose the acne type and severity, check for underlying causes (hormones, meds, PCOS), and prescribe treatments that aren’t available OTC.
• How: use the American Academy of Dermatology “Find a Dermatologist” tool for local in‑person care. If you want remote care, consider telederm services such as Curology or Apostrophe — they connect you with licensed providers and can prescribe topical and some oral meds.

1. What the dermatologist may recommend (brands/examples and why)

• Prescription topical retinoid: tretinoin (Retin‑A) or tazarotene (Tazorac). More effective than OTC retinoids at normalizing follicles and preventing new lesions.
• Prescription topical combos: tretinoin or adapalene combined with topical antibiotics or benzoyl peroxide, or custom formulas from Curology (they often include tretinoin/clindamycin/azelaic acid) for tailored therapy.
• Azelaic acid: Finacea (15% gel, prescription) or over‑the‑counter options like The Ordinary Azelaic Acid 10% — helpful for inflammatory lesions and post‑inflammatory pigmentation.
• Oral antibiotics (short-term): doxycycline or minocycline for inflammatory acne while topical meds take effect.
• Hormonal treatment (for people who menstruate): combined oral contraceptives proven for acne (brands include Ortho Tri‑Cyclen, Yaz, Estrostep) or spironolactone (Aldactone/generic spironolactone) — excellent for hormonally driven adult acne.
• Isotretinoin (Accutane/generic isotretinoin): for severe or treatment‑resistant cystic acne. Highly effective but requires monitoring and strict pregnancy‑prevention measures (iPLEDGE in the U.S.).
• In‑office procedures: cortisone injection for painful cysts, salicylic/chemical peels, light/laser treatments, or microneedling can speed improvement or reduce scarring.

1. What to tell your clinician (helps them pick the right plan)

• Duration and pattern of acne, previous treatments (products & prescription meds), menstrual history (if applicable), other meds, major health issues, and whether scarring is present or you have painful cysts.

1. Short-term regimen you can use while you arrange care

• Gentle cleanser twice daily: CeraVe Hydrating Cleanser or Cetaphil Gentle Skin Cleanser.
• Spot or leave-on acids: salicylic acid—Paula’s Choice 2% BHA (helps unclog pores) OR benzoyl peroxide 2.5–5% (PanOxyl, La Roche‑Posay Effaclar Duo) for inflammatory lesions. Use one active at a time to limit irritation.
• Lightweight, non‑comedogenic moisturizer: CeraVe PM, Vanicream, or Neutrogena Hydro Boost.
• Sunscreen (important if using retinoids/peels): EltaMD UV Clear is widely recommended for acne‑prone skin (contains niacinamide).
• Avoid harsh scrubs, picking, or using multiple prescription actives at once.

1. What to expect

• Prescription topical retinoids often take 8–12 weeks to show substantial benefit; combining therapies shortens time to improvement.
• Oral antibiotics are usually short‑term (a few months) and often used with topicals.
• Hormonal therapies and spironolactone may take 3 months or more to show benefit.
• Isotretinoin can produce long‑term remission but has significant side effects and monitoring requirements.

1. If you suspect a hormonal cause

• Ask your dermatologist about hormonal evaluation (blood tests) or a trial of spironolactone or an appropriate combined oral contraceptive.

If you’d like, tell me:

• your sex, age, a brief description of your acne (where it is, if it’s cystic, scarring), and what you’ve already tried — I can suggest what to ask the dermatologist and what options are most likely to help.