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

Sorry it’s been frustrating — adult acne that won’t clear with drugstore products is common, and there are effective next steps. Here’s a clear plan and specific options to discuss with a clinician.

1. See a dermatologist (in-person or online)

• Why: A skin exam identifies the acne type and severity and avoids wasting time on ineffective OTC products.
• Options: Book a local board‑certified dermatologist or use a reputable online prescription service like Curology or Apostrophe for a customized prescription regimen.

1. Prescription treatments your dermatologist may recommend

• Topical prescription retinoids: tretinoin (Retin-A) or prescription-strength adapalene (stronger than OTC Differin 0.1%). These normalize cell turnover and reduce comedones.
• Topical antimicrobials/anti‑inflammatories: dapsone gel (Aczone) or topical antibiotics often combined with benzoyl peroxide.
• Azelaic acid: prescription Finacea (15% gel) is good for inflammation and post‑inflammatory hyperpigmentation; OTC option: The Ordinary Azelaic Acid 10% Suspension.
• Oral antibiotics: doxycycline or minocycline for moderate inflammatory acne — usually short term and combined with topical therapy.
• Hormonal therapy (for people who menstruate): combined oral contraceptives FDA‑approved for acne (e.g., Ortho Tri‑Cyclen, Yaz) or spironolactone (off‑label) to reduce androgen-driven acne.
• Isotretinoin (Accutane and generic isotretinoin): for severe or treatment‑resistant nodulocystic acne — often curative but requires specialist monitoring (pregnancy prevention programs, labs).

1. Practical skincare (to use alongside prescription therapy)

• Gentle cleanser: CeraVe Foaming Facial Cleanser or La Roche‑Posay Toleriane Cleanser.
• Non‑comedogenic moisturizer: CeraVe PM or La Roche‑Posay Toleriane Double Repair.
• Sunscreen: EltaMD UV Clear (good for acne/prone and helps with irritation from treatments).
• If you haven’t tried it, Differin Gel (adapalene 0.1%) is an OTC retinoid that helps many people — but prescription-strength retinoids are often more effective.

1. In‑office/cosmetic options (adjuncts, not replacements for medical therapy)

• Chemical peels, light/laser treatments, or extractions performed by dermatologists or dermatologic providers can help faster, especially for scarring and persistent lesions. Ask a dermatologist which is right for you.

1. Lifestyle and expectations

• Avoid harsh scrubs and picking. Use non‑comedogenic makeup.
• Some people find reducing high‑glycemic foods or skim milk helps; evidence is modest.
• Prescription treatments often take 8–12 weeks to show meaningful improvement.

1. What to say when you book the appointment

• “I’ve had persistent adult acne for [time], OTC products haven’t helped, and I’d like an effective treatment plan.” Mention any menstrual cycle pattern or recent medication/health changes.

If you’d like, tell me:

• your age and sex,
• what acne looks like (comedonal vs inflamed vs deep nodules),
• what drugstore products you’ve tried and for how long, and I can suggest more tailored next steps and questions to bring to a dermatologist.