Adult Acne Treatment (Acne Vulgaris)
Fast MD-only acne care by secure online video visit, $49 flat-fee, no insurance required.
Adult acne is a chronic inflammatory skin condition that can cause clogged pores, pimples, and painful nodules on the face, chest, or back. Our board-certified MDs use guideline-based evaluation to classify acne severity, identify triggers, and build an evidence-based treatment plan that fits your skin type and lifestyle.
- $49 flat-fee adult visit
- MD-only care (no mid-levels)
- No insurance required
- Secure video visits in 25+ states
Online MD-Only Acne Care
- Adult-only evaluation for facial, chest, and back acne
- Severity-based treatment (mild, moderate, selected severe)
- Topical and, when appropriate, systemic therapies
- Clear criteria for when in-person dermatology is needed
Adults 18+ only. No isotretinoin or controlled substances are prescribed through TeleDirectMD.
What Is Adult Acne (Acne Vulgaris)?
Adult acne (acne vulgaris) is a common inflammatory skin condition involving the hair follicles and oil glands. It is driven by a combination of excess sebum production, clogged pores, skin bacteria, and inflammation, often influenced by hormones, genetics, stress, and cosmetics. Lesions can include blackheads, whiteheads, red bumps, pustules, and in more severe cases, deeper nodules or cysts.
Acne can persist into adulthood or start for the first time in your 20s, 30s, or later. It is not simply a hygiene problem and often requires a structured regimen of topical and sometimes oral medications. Mild to moderate acne and many chronic stable cases can be safely evaluated and treated by telehealth, as long as red-flag features are not present.
Symptoms and Red Flags in Adult Acne
Most acne can be managed through a virtual visit, but some patterns or symptoms suggest a more serious skin disorder, medication side effect, or systemic illness that needs in-person evaluation.
| Symptom | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Blackheads and whiteheads (open and closed comedones) | Mild non-inflammatory acne | Yes, typically well-suited for telehealth | Not a red flag by itself |
| Small red bumps and pustules on face | Mild to moderate inflammatory acne | Yes, if skin intact and patient stable | Rapidly spreading redness, warmth, or pain |
| Acne on chest and back in addition to face | More extensive acne, may require combination therapy | Often appropriate for telehealth initial management | Extensive painful nodules, systemic symptoms, or suspicion of infection |
| Deep, painful nodules or cysts | More severe or nodulocystic acne with scarring risk | Telehealth can help triage and start care | Severe pain, fevers, or rapidly worsening lesions |
| Acne with sudden onset after starting a new medication | Possible medication-induced acneiform eruption | Telehealth may be appropriate for initial review | Systemic symptoms or severe, rapid eruption |
| Acne-like bumps with flushing and visible blood vessels | Rosacea, periorificial dermatitis, or other diagnosis | Often manageable via telehealth | Eye pain, vision changes, or severe facial swelling |
| Acne with significant scarring or disfiguring lesions | Long-standing inflammatory acne, high scarring risk | Telehealth can start medical therapy and refer | Very aggressive course with systemic symptoms |
| Fever, joint pain, or feeling very ill with skin lesions | Possible serious drug reaction or systemic disease | No | Requires urgent in-person or emergency evaluation |
| Widespread blistering, skin peeling, or mucosal involvement | Severe cutaneous adverse drug reaction | No | Emergency evaluation is required |
Differential Diagnosis: Acne vs Other Adult Facial Eruptions
Not every breakout is classic acne. During your TeleDirectMD visit, the MD will assess the lesion type, distribution, timing, and triggers to distinguish acne from other conditions that may look similar but require different treatment.
Acne Vulgaris (Typical Adult Acne)
- Combination of comedones (blackheads and whiteheads), papules, and pustules
- Primarily affects face, jawline, chest, and back
- Often chronic or relapsing, may flare with hormones or stress
- Improves with retinoids, benzoyl peroxide, and sometimes oral antibiotics
Other Conditions That Mimic Acne
- Rosacea: Central facial redness, flushing, visible blood vessels, and papules; often worsened by heat, alcohol, or spicy foods.
- Periorificial dermatitis: Small bumps around mouth, nose, or eyes, often linked to topical steroid or cosmetic use.
- Folliculitis: Infected or inflamed hair follicles, sometimes from shaving, friction, or hot tubs.
- Medication-induced acneiform rash: Monomorphic papules or pustules after starting certain medications.
Telehealth can often distinguish these based on video examination and history. When the diagnosis is uncertain, severe, or not responding to guideline-based therapy, in-person dermatology evaluation may be recommended.
When Is a Video Visit Appropriate for Adult Acne?
When a Video Visit Is Appropriate
- Mild to moderate facial acne without systemic symptoms
- Stable chest or back acne in an otherwise well adult
- Chronic, relapsing acne that needs a more structured regimen
- Partial response or irritation with prior over-the-counter products
- No fever, joint pain, or diffuse rash with blistering or peeling
- Patient can clearly show lesions on camera and follow instructions
- Adult 18+ who can safely obtain and use prescribed medications
Red Flags Requiring In-Person or ER Care
- Sudden onset of widespread painful rash, blisters, or skin peeling
- Fever, joint pain, or feeling very ill with skin lesions
- Rapidly spreading redness and warmth concerning for skin infection
- Severe nodulocystic acne with extensive scarring or facial swelling
- Eye pain, vision changes, or painful swelling around the eyes
- Recent new medication with concerning systemic side effects
- Known immunosuppression with rapidly progressing lesions
If any red-flag symptoms are present, seek in-person or emergency care immediately. TeleDirectMD is not an emergency service.
Treatment Options for Adult Acne
Effective acne treatment usually includes a combination of topical agents, skin-care habit changes, and in some cases oral medications. Our MDs follow evidence-based guidelines and focus on balancing efficacy with tolerability and long-term safety.
Supportive Skin-Care and Lifestyle Measures
- Use a gentle, non-comedogenic cleanser once or twice daily.
- Avoid harsh scrubs, picking, or squeezing lesions, which increases scarring risk.
- Choose oil-free, non-comedogenic moisturizers and cosmetics.
- Use non-greasy sunscreen daily, especially with topical retinoids or benzoyl peroxide.
- Identify potential triggers such as certain cosmetics, occlusive masks, or hair products.
First-Line Prescription Options (When Appropriate)
- Topical retinoids (e.g., adapalene, tretinoin) to normalize follicular shedding and prevent clogged pores.
- Benzoyl peroxide to reduce Cutibacterium acnes and inflammation.
- Topical antibiotics, typically in combination with benzoyl peroxide, to limit resistance.
- For selected moderate cases, oral antibiotics for limited duration alongside topical regimen.
- Hormonal therapy (e.g., certain oral contraceptives, spironolactone) may be discussed but often requires continuity and coordination with primary care or in-person care depending on the patient.
TeleDirectMD does not initiate isotretinoin or prescribe controlled substances for acne. Patients with severe, scarring, or refractory disease may be referred for in-person dermatology evaluation and potential isotretinoin consideration.
Common Medications Used for Adult Acne
The exact treatment plan is individualized based on acne type, severity, prior therapies, other medical conditions, and patient preferences. The table below shows typical examples your MD may consider.
| Medication | Dose | Duration | When it is used |
|---|---|---|---|
| Adapalene 0.1% gel | Apply pea-sized amount to entire affected area once nightly | Ongoing; reassess at 8–12 weeks | First-line topical retinoid for comedonal and mild inflammatory acne |
| Tretinoin 0.025% cream | Apply thin layer at night, starting 2–3 times per week and increasing as tolerated | Ongoing; reassess at 8–12 weeks | Alternative retinoid for adults who can tolerate gradual titration |
| Benzoyl peroxide 2.5–5% wash or gel | Apply once daily to affected areas; rinse off if wash formulation | Ongoing; often combined with other agents | Reduces C. acnes and inflammation; decreases resistance when used with topical or oral antibiotics |
| Clindamycin 1% topical (often in combo with benzoyl peroxide) | Apply thin layer once or twice daily to inflamed areas | Limited course; reassess at 8–12 weeks | Used for inflammatory papules and pustules, always with benzoyl peroxide to limit resistance |
| Doxycycline 100 mg | 100 mg once or twice daily with food as tolerated | Typically 8–12 weeks with topical regimen | Selected moderate inflammatory acne when topical therapy alone is insufficient and no contraindications |
| Spironolactone (dose individualized) | Example: 50–100 mg daily; dosing individualized | Months; requires monitoring and follow-up | Adult females with hormonally influenced acne when appropriate and after risk–benefit discussion |
These are example regimens only. Actual medications, strengths, and durations are determined by the MD after reviewing your history, skin type, other diagnoses, and concurrent medications. TeleDirectMD does not prescribe isotretinoin or controlled substances via telehealth.
Home Care, Expectations, and Return to Work
Acne treatment requires consistency and realistic expectations. Most evidence-based regimens take several weeks to show noticeable improvement, with continued gains over months.
- Use medications exactly as directed; avoid abruptly stopping after just a few days.
- Expect mild dryness, peeling, or irritation early with retinoids; your MD can help adjust frequency.
- Continue non-comedogenic skin care and sun protection to support long-term control.
- Avoid picking or popping lesions to reduce the risk of scarring and dark marks.
- Schedule follow-up if you are not improving after a reasonable trial or are having side effects.
Most adults with acne can safely attend work, school, and social activities. If a work note is needed, TeleDirectMD can generally provide documentation of evaluation and treatment rather than recommending time off unless other medical issues are present.
TeleDirectMD Telehealth Disclaimer
TeleDirectMD provides MD-only virtual urgent care for adults using secure video visits to evaluate conditions like adult acne. Visits are $49 flat-fee with no insurance required and are available in 25+ states. Our physicians follow evidence-based guidelines, clarify what can be safely managed via telehealth, and explain when in-person primary care or dermatology is more appropriate. TeleDirectMD is not an emergency service or a replacement for comprehensive in-person care.
Adult Acne Treatment FAQs
Adult acne often centers around the lower face and jawline, may be influenced more by hormones, stress, and cosmetics, and can be more persistent than teenage acne. The core mechanisms are similar, but adults often need tailored regimens that consider skin sensitivity, work schedule, and other medications or conditions.
Yes. Most mild to moderate adult acne can be safely evaluated and treated by an MD via secure video. We assess lesion type, severity, and distribution, review your medications and medical history, and then build a guideline-based plan. If we see features suggesting a more serious condition, we will direct you to in-person care instead.
Most evidence-based regimens take at least 6–8 weeks to show meaningful improvement, with continuing gains over 3–6 months. It is normal not to see overnight results. Consistent use and follow-up adjustments are key to success, which telehealth can help support.
Depending on your case, we may recommend topical retinoids, benzoyl peroxide, combination products with topical antibiotics, and for some adults, a limited course of oral antibiotics or discussion of hormonal options. We do not start isotretinoin through telehealth but can refer you to in-person dermatology when that is appropriate.
Topical retinoids help normalize how cells shed inside the hair follicle, preventing clogged pores and comedones. They also have anti-inflammatory benefits. They are a cornerstone of modern acne therapy but must be introduced gradually to minimize dryness and irritation. Your MD will give you a stepwise plan to tolerate them better.
Oral antibiotics are generally reserved for moderate inflammatory acne when topical therapy alone is not enough and there are no contraindications. They are used together with topical agents for a limited time, often around 8–12 weeks, to reduce inflammation. They are not meant as stand-alone long-term therapy or a quick fix without a topical regimen.
No. TeleDirectMD does not start isotretinoin through telehealth because it requires intensive monitoring, lab testing, and strict safety protocols. If your acne is severe, scarring, or has failed appropriate treatments, we can recommend in-person dermatology follow-up where isotretinoin may be considered if appropriate for you.
Some adult women benefit from hormonal strategies such as certain oral contraceptives or spironolactone, particularly when breakouts worsen around the menstrual cycle or along the jawline. Whether this is appropriate for you depends on your health history, medications, and risk factors. Telehealth can help start the discussion, but ongoing management may be coordinated with primary care or in-person care depending on your circumstances.
In-person dermatology is recommended for very severe or scarring acne, suspected unusual diagnoses, possible medication reactions, or when you may be a candidate for isotretinoin. If your acne does not respond to guideline-based regimens, needs procedures such as injections or peels, or has major impact on quality of life, in-person specialty care is appropriate.
No. While gentle cleansing is important, acne is not simply a result of dirty skin. It reflects complex interactions between hormones, oil production, bacteria, and inflammation. Over-washing, scrubbing, or using harsh products can actually worsen irritation and delay improvement.
TeleDirectMD offers MD-only, guideline-based acne care through secure video visits with a simple $49 flat-fee model and no insurance required in 25+ states. We focus on clear expectations, rational medication use, antibiotic stewardship, and specific instructions for when in-person dermatology or urgent care is safer for you.