I used to use this forum as a reference when my acne was at its worst. I've been clear for about 2 years and thought I'd share what has worked for me! I'm definitely not promoting any products here, but just wanted to share what my solution has been, since I used to desperately scour these forums looking for solutions.
About 3 years ago, I developed horrific cystic acne around the jawline, chin, and mouth. I had been using Proactiv in the years prior to that, and it had always worked. I didn't realize it at first, but his acne was internal, and no topical treatments were going to work anymore. At the time I had no idea that this type of acne was hormonal, that it was an entirely different beast to the minor acne I'd had before. I tried EVERYTHING: Clinique, La Roche Posay, Murad... I spent so much money on luxury skincare acne products, and nothing worked.
After about a year, when I finally realized topical treatments were not doing anything, I saw an incredible dermatologist who is really well reputed in my region. She put me on Yaz birth control pills, benzoyl peroxide/clindamycin (Duac) gel in the mornings, and Retin-A Micro (0.04%) at night. She said she usually sees better results in patients who use a combination of two different topicals instead of just one, plus a way to treat hormones from the inside out.
I still get a minor hormonal breakout each month, usually one or two cystic lesions on the chin, but my skin is the best it's been since that horrific year and I'll gladly deal with this. Plus I often have long stretches with no major breakouts.
I really hope all of you with dreadful cystic hormonal acne find your cures! I know how crippling and humiliating it can be. Good luck!