Adult Acne Treatment (Acne Vulgaris)
MD-only online acne evaluation for adults in California with guideline-based severity assessment, evidence-based topical treatments, and clear safety screening for cystic acne and scarring risk. $49 flat-fee video visit, no insurance required.
Most adult acne improves with consistent topical therapy and a simple routine. TeleDirectMD focuses on evidence-based, non-controlled treatments and clear expectations for when in-person dermatology care is safer.
- Assessment: comedonal vs inflammatory vs cystic patterns
- Evidence-based topicals such as retinoids and benzoyl peroxide
- Guidance for irritation control and hyperpigmentation prevention
- Adults only (18+), video visit only
What Is Acne Vulgaris?
Acne vulgaris is a common skin condition caused by clogged hair follicles, excess oil production, bacteria on the skin, and inflammation. It can present as blackheads and whiteheads (comedonal acne), inflamed bumps (papules and pustules), or deeper painful cysts and nodules.
Adult acne often involves the lower face and jawline and may flare with stress, hormonal shifts, or certain skin products. TeleDirectMD builds a stepwise plan focused on reducing breakouts, preventing scarring, and simplifying daily skin care.
California has several predictable acne triggers: higher year-round UV exposure, heat waves and sweating in many regions, and dry air in inland areas that can lead to over-cleansing and barrier irritation. TeleDirectMD tailors acne routines to California conditions by emphasizing non-comedogenic sunscreen, gentle cleansing, and moisturizing strategies that prevent rebound oiliness.
Symptoms and Red Flags
| Symptom | What it suggests | Telehealth appropriate? | Red flag requiring urgent in-person care |
|---|---|---|---|
| Blackheads and whiteheads | Comedonal acne | Often yes | Rapid progression or significant scarring |
| Red bumps or pustules | Inflammatory acne | Often yes | Painful swelling with spreading redness or fever |
| Deep painful cysts or nodules | Nodulocystic acne, higher scarring risk | Sometimes | Rapid scarring or severe widespread cysts |
| Jawline flares around menses | Hormonal pattern acne | Often yes | New severe acne with other systemic symptoms |
| Dark spots after acne heals | Post-inflammatory hyperpigmentation | Often yes | None typically |
| Spreading redness, warmth, pus, fever | Possible skin infection | Often no | Urgent in-person evaluation |
What Else Can Look Like Acne?
Folliculitis
Follicle inflammation often triggered by sweat, friction, or occlusive products. It can be itchy and appear uniform.
Rosacea
Facial redness and bumps often without blackheads. Flare triggers may include heat, alcohol, spicy foods, and sun.
Perioral dermatitis
Small bumps around the mouth and nose, sometimes worsened by topical steroids or heavy facial products.
Contact dermatitis
Irritant or allergic rash triggered by products. Can mimic acne with redness and small bumps.
Keratosis pilaris
Rough follicular bumps, common on arms and thighs, often not inflamed like acne.
Medication-related acneiform eruptions
Uniform breakouts linked to certain medications or supplements. Timing and exposures matter.
Telehealth Eligibility
Many adults can safely manage acne through telehealth with a structured plan and consistent follow-through.
When a Video Visit Is Appropriate
- Adult 18+ with acne on face, chest, or back without infection signs
- Mild to moderate comedonal or inflammatory acne
- Stable symptoms without rapid scarring progression
- Able to follow a topical routine and monitor response
- Physically located in California at the time of the visit
Red Flags Requiring In-Person Care
- Deep painful cysts or nodules with rapid scarring
- Severe widespread acne that may require systemic therapy
- Spreading redness, warmth, pus, or fever suggesting infection
- Rapidly worsening rash, facial swelling, or severe pain
- Pregnancy related medication safety questions requiring tailored planning
Treatment Options
Core topical routine
- Gentle cleanser and non-comedogenic moisturizer
- Topical retinoid to prevent clogged pores
- Benzoyl peroxide to reduce bacteria and inflammation
Inflammatory acne options
- Topical clindamycin used with benzoyl peroxide when appropriate
- Azelaic acid may help acne and hyperpigmentation in selected patients
- Gradual ramp-up improves tolerance
Scarring prevention
- Avoid picking or squeezing lesions
- Reassess at 8 to 12 weeks for meaningful change
- Lower threshold for in-person referral for cystic acne
Sunscreen and acne in California
Daily sunscreen is important in California, but some formulas can clog pores. Look for non-comedogenic, oil-free, or gel sunscreens. If breakouts worsen after starting a product, switching sunscreen alone can make a meaningful difference.
How to use actives without irritation
Start retinoids every other night and increase as tolerated. Use moisturizer to reduce dryness. Irritation is common early on and usually improves as the skin adapts.
TeleDirectMD does not prescribe controlled substances. For severe nodulocystic acne that may require systemic therapy, your physician will help direct you to appropriate in-person care.
Medication Table
Common adult topical regimens are listed below. Treatment is individualized based on acne pattern, skin sensitivity, and pregnancy status when relevant.
| Medication | Dose | Duration | When used |
|---|---|---|---|
| Tretinoin cream | 0.025% to 0.05% apply thin layer nightly | 8 to 12 weeks minimum | Comedonal or mixed acne, prevention of new lesions. |
| Adapalene gel | 0.1% apply thin layer nightly | 8 to 12 weeks minimum | Alternative retinoid option, often well tolerated. |
| Benzoyl peroxide wash | 2.5% to 5% use once daily | Ongoing | Inflammatory acne, helps reduce resistance risk when used with topical antibiotics. |
| Clindamycin topical | 1% apply once daily | 8 to 12 weeks | Inflammatory acne, typically used with benzoyl peroxide. |
| Azelaic acid | 15% to 20% apply 1 to 2 times daily | 8 to 12 weeks minimum | Acne with hyperpigmentation or sensitive skin in selected patients. |
Home Care and Daily Routine
Routine tips
- Use fragrance-free, non-comedogenic products
- Start actives every other night if sensitive, then increase as tolerated
- Use sunscreen daily because retinoids increase sun sensitivity
- Shower after heavy sweating and avoid tight occlusive clothing on acne-prone areas
- On hot days or after workouts, rinse or shower soon after sweating and change out of tight clothing to reduce follicle irritation on the back and chest
- If you wear sunscreen daily, cleanse at night with a gentle cleanser to remove sunscreen without over-scrubbing
When to recheck
- No improvement after 8 to 12 weeks of consistent use
- New scarring or painful cystic acne
- Severe irritation, peeling, or rash from products
- Signs of infection or rapidly worsening skin changes
During wildfire smoke events, some people notice more skin irritation and breakouts. Keeping routines simple, avoiding harsh exfoliants, and focusing on barrier support can help.
Acne treatment is a consistency problem more than a product problem. Most plans need at least 8 to 12 weeks to show meaningful improvement.
TeleDirectMD acne visits
TeleDirectMD provides MD-only virtual urgent care for adults for $49 flat-fee video visits in 25+ states. Your physician assesses acne type and severity, prescribes evidence-based topical treatments when appropriate, and provides practical routine guidance and red-flag screening for scarring risk or infection. No controlled substances are prescribed.