I am in my late 30s and had a HORRIBLE breakout on my chin about 8 months ago. It was so cystic that they thought I had some sort of secondary infection. And my skin was perfectly clear everywhere else on my face!

I used to have a great derm but I moved and found that the Derms in my new state were not addressing the obvious hormonal component to my acne outbreak. After trying a slew of meds that were expensive and not working, I stopped going to the dermatologist other than for antibiotics. I am definitely not recommending not going to a Dermatologist but thought maybe some component of my regimen would be helpful to others....

[list]

[*]Solydyn (Minocycline) for 12 weeks now. Takes 8-10 weeks to see a difference. I want to stop these but want to wait until I am acne free for a few months.
[*]Birth Control Pill: on my fifth month (Ortho-Cyclen which is a monophasic). I saw results at 4 months but did get better with each month that passed. I was also going to try Yasmin, Paz but wanted to start with one that I had already been on in the past.
[*]Bi-weekly facials (medical not spa): I found a medical esthetician who is extremely knowledgeable and patient. We tried a few different peels and this is where we are after a few months: Bi-weekly Salicylic Acid peels, Microdermabrasion (started this only when my skin was closer to healing) and Ultrasound. I use Rhonda Allison products exclusively: Beta green tea wash, Pumice scrub with Blueberries, Zinc Protection Cream and Cleansing pads after workouts when I can't wash my face right away. I also use the Skin Smoothing Gel and Blemish Serum. It is not a cheap regimen but it is working so it is worth it.
--I also started using these products that don't contain bismuth which is very acnegenic for some people....www.beautyblisscosmetics.com. I was previously using Bare Escentuals but stopped.

I also tried red and blue light treatments but it made it worse...from what I read these treatments seem to work better on mild to moderate acne and mine was too cystic...

After about 5 months of the Pill, almost 4 on the Antibiotics, and about 5 months of facials, my acne is 99% gone. I get an occasional very small cyst around the 2-3rd week of the Pill but I welcome that compared to what I looked like 8 months ago.

I hope this info helps someone out there!