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

You’re right to be concerned if drugstore products haven’t helped — adult acne often needs prescription care or a different approach. Here’s a clear, practical plan and specific brands/services to consider.

1. See a dermatologist (or a reputable telederm)

• Why: a clinician can evaluate type/severity (inflammatory, hormonal, nodulocystic, scarring) and prescribe more effective therapies and monitor side effects.
• In-person: use the American Academy of Dermatology find-a-derm or Zocdoc to book a board-certified dermatologist near you.
• Telederm options (convenient, can prescribe):
  • Curology — customized topical prescriptions (retinoid + other active ingredients).
  • Apostrophe — dermatology consultations and prescription plans.
  • Hers — geared to women, offers hormonal acne management (spironolactone) and prescription topicals; also manages isotretinoin. These services can be faster/cheaper than an office visit and are good if you don’t need an exam for nodules/scarring.

1. Prescription treatments your dermatologist may recommend (and why)

• Topical prescription retinoids (tretinoin, tazarotene): normalize skin cell turnover, prevent clogged pores; stronger and more effective than most OTC retinoids.
• Topical combination therapy (retinoid + benzoyl peroxide or topical antibiotic): treats multiple causes at once.
• Azelaic acid (prescription options like Finacea): anti-inflammatory, helps pigmentation from breakouts.
• Oral antibiotics (doxycycline, minocycline) for moderate inflammatory acne — used short-term to reduce bacteria and inflammation.
• Hormonal treatments (for people who menstruate): combined oral contraceptives FDA-approved for acne (e.g., Ortho Tri-Cyclen, Yaz), or spironolactone (commonly used off-label) to reduce androgen-driven acne.
• Isotretinoin (Accutane) for severe, nodular, or scarring acne — highly effective but requires close monitoring and pregnancy prevention (iPLEDGE program in the U.S.).

1. Skincare routine to use alongside prescriptions

• Gentle cleanser twice daily: CeraVe Foaming Cleanser or La Roche-Posay Effaclar Medicated Cleanser (salicylic acid).
• Non-comedogenic moisturizer to reduce irritation: CeraVe PM, Vanicream, or La Roche-Posay Toleriane.
• Daily sunscreen (crucial, especially with retinoids): EltaMD UV Clear (great for acne-prone/rosacea-prone skin).
• Avoid abrasive scrubs, over-drying cleansers, and picking/popping pimples.

1. Timeline and expectations

• Prescription topical/antibiotic/hormonal regimens often need 8–12 weeks to show meaningful improvement. Spironolactone or hormonal pills may take 3 months or more.
• Isotretinoin is usually a 4–6 month course with dramatic results for many people.

1. When to see a specialist urgently

• Large, painful nodules, rapidly spreading lesions, or early scarring — see a dermatologist promptly.
• If acne affects your mood, self-esteem, or daily functioning — mention this to your clinician; mental health support is important.

1. Safety notes

• If you’re pregnant, planning pregnancy, or breastfeeding, avoid retinoids and isotretinoin. Tell any provider right away.
• Some meds require monitoring (liver tests, lipids, pregnancy tests for isotretinoin; potassium monitoring for high-dose spironolactone in certain patients).

If you want, tell me: your sex, age, how long you’ve had acne, what prescription or OTC products you’ve tried, and whether you have scarring or painful cysts — I can suggest the most likely next steps and which telederm or in-person options might suit you best.