I'm a 28 year old female for whom accutane failed. After it was out of my system, 6 months after I ended my treatment, my cystic acne came back with a vengeance immediately. I've more or less had some form of acne since about age 12. When I was 19 however, that's when my acne started to change more from typical teenage acne to the adult cheek/jawline cystic acne I now have that seems to get worse as I age. I really thought accutane was my cure, but once my cystic acne started to come back again, I was very discouraged. (I've now been off accutane for a year any my cystic acne is arguably worse than it's ever been). I originally came across a potential link between a thyroid issue and acne after reading about what paths some women took after acutane failed. It never occurred to me that a thyroid issue could be the root cause, but hyperthyroidism actually runs in the women in my family. Both my aunt (on my father's side) and grandmother (on my mother's side) have been inordinately thin with very high metabolism all of their lives, as is the case with me as well, and have been treated for the issue. I am now hoping that it's true that my acne is related to this and that getting it under control will help. With my aunt, there was a connection between roesacea and her thyroid, but she never suffered from the severe cystic acne that I have. This is the one avenue that is giving me hope after literally everything else has failed me. I just need to get some more details about my family history and make a doctor's appointment. (With an endocrinologist, not a dermatologist). I hope this is a solution.