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

It's incredibly frustrating when adult acne persists despite trying drugstore options! This usually means it's time to bring in the big guns – often a combination of professional guidance and targeted medical-grade products.

Here's a breakdown of what you should do, including specific brands and services:

1. See a Dermatologist (Most Important First Step): This is the absolute best starting point. Adult acne often has different causes than teenage acne (like hormones) and requires prescription-strength treatments.

   • Why: A dermatologist can accurately diagnose the type of acne you have (e.g., hormonal, cystic, fungal, inflammatory) and create a personalized treatment plan. They can also rule out underlying medical conditions.
   • What they might prescribe:
     • Topical Retinoids: Such as Tretinoin (Retin-A, Renova) or Adapalene (Differin - now OTC but prescription strength is stronger). These increase cell turnover and unclog pores.
     • Oral Medications: For persistent or severe cases, they might prescribe:
       • Spironolactone: Often used for hormonal acne, especially in women.
       • Antibiotics: (e.g., Doxycycline, Minocycline) to reduce inflammation and bacteria.
       • Isotretinoin (Accutane): For very severe, scarring acne that hasn't responded to other treatments.
     • Other Topicals: Like Dapsone (Aczone) or stronger concentrations of Azelaic Acid or Clindamycin.
   • How to access: Find a local dermatologist. Many practices also offer telehealth appointments for initial consultations or follow-ups, which can be convenient.

2. Consider Telehealth Dermatology Services: If getting to a traditional dermatologist is difficult, these services can connect you with prescribers online.

   • Why: They offer convenience and access to prescription-strength topical treatments tailored to your skin.
   • Specific Services:
     • Curology: They match you with a provider who formulates a custom topical cream with ingredients like Tretinoin, Azelaic Acid, Clindamycin, or Niacinamide.
     • Apostrophe: Similar to Curology, they offer custom formulas and can also prescribe oral medications like Spironolactone.
     • Agency Skincare: Sister company to Curology, often focuses on anti-aging and acne, providing custom formulas.

3. Optimize Your At-Home Skincare (While Waiting for a Derm or Alongside Treatment): Even if drugstore products failed, medical-grade or specific formulations can make a difference. The key is gentle, consistent care.

   • Cleanser: Use a gentle, hydrating cleanser.
     • Brands: CeraVe Hydrating Facial Cleanser, La Roche-Posay Toleriane Hydrating Gentle Cleanser. Avoid harsh scrubbing.
   • Targeted Treatment (OTC options that are stronger):
     • Adapalene Gel: Differin Gel (0.1% strength is OTC). This is a retinoid that helps with cell turnover and can be a good bridge before stronger prescriptions.
     • Benzoyl Peroxide: Excellent for killing acne-causing bacteria. Look for concentrations of 2.5% to 5% to minimize irritation.
       • Brands: PanOxyl Acne Foaming Wash (10% BP) (use sparingly if sensitive), La Roche-Posay Effaclar Duo Dual Action Acne Treatment (5.5% BP).
     • Salicylic Acid (BHA): Helps exfoliate inside the pores.
       • Brands: Paula's Choice 2% BHA Liquid Exfoliant (a cult favorite), Cosrx BHA Blackhead Power Liquid.
     • Azelaic Acid: Reduces inflammation, kills bacteria, and gently exfoliates.
       • Brands: The Ordinary Azelaic Acid Suspension 10%, Paula's Choice 10% Azelaic Acid Booster.
   • Moisturizer: Crucial to prevent dryness and support your skin barrier, especially with active treatments. Choose non-comedogenic.
     • Brands: CeraVe PM Facial Moisturizing Lotion, La Roche-Posay Toleriane Double Repair Facial Moisturizer.
   • Sunscreen: Non-negotiable, especially when using active ingredients that make your skin more sensitive to the sun.
     • Brands: EltaMD UV Clear Broad-Spectrum SPF 46 (designed for acne-prone skin), Supergoop! Unseen Sunscreen SPF 40.

4. Consider Professional Esthetician Services (Complementary): Once you're on a stable regimen from a dermatologist, an esthetician can help with maintenance and addressing scarring/texture.

   • Why: They can perform gentle extractions, offer chemical peels, or other treatments that complement your medical regimen, but they cannot prescribe. Always coordinate with your dermatologist.
   • Services: Look for an esthetician specializing in acne or a "medical spa" that works in conjunction with a dermatologist.
     • Acne Facials: Focus on deep cleansing and gentle extractions.
     • Chemical Peels: (e.g., salicylic acid, glycolic acid) can help with exfoliation and improving skin texture.

5. Lifestyle Adjustments (Supportive): While not a direct "fix," these can help manage triggers.

   • Diet: Some people find reducing dairy, high-glycemic foods, and excessive sugar can help. This is very individual, but worth exploring if you notice patterns.
   • Stress Management: High stress levels can worsen acne. Practicing mindfulness, exercise, or ensuring adequate sleep can help.
   • Cleanliness: Regularly change pillowcases, clean your phone screen, and avoid touching your face.

Key Takeaway: Don't get discouraged! Adult acne is common and treatable. Your best course of action is to consult a dermatologist who can provide a tailored medical solution. Be patient and consistent with whatever plan you pursue, as it often takes several weeks or months to see significant improvement.