I don't have a definitive answer for my skin problems, but after 16 years of trying to resolve my teenage and then adult acne there are a few things that I can recommend and a few things that exacerbate my acne.
I think my acne is largely hormonal because it worsens around ovulation and responds to stress and exercise (related to androgen production)
My skin reacts to stress MASSIVELY. If I keep the stress down, my skin is calmer (I am a mild acne sufferer).
I'm not 100% on this, but I have noticed that during periods of eating less crap (I'm an all or nothing gal: I tend to binge eat or binge diet i.e. cut out all processed, sugary foods) my skin has been less bad. For example, when I tend to cut out anything with massively high sugar content (i'm talking chocolate, doughnuts, biscuits, cakes, sweets etc), my skin thanks me for it.
However, I tend to binge when I'm stressed so it's hard to disentangle stress from high GI.
Good things for my skin:
I should note here that eating healthily per se has never stopped a breakout, it's cutting out the highly sugary foods which I've noticed has helped the most.
Initially my skin reacted badly to lots of exercise, however, after about 3 weeks of CV and weights I noticed an improvement in my skin clarity (this could be directly due to the exercise or also due to more hydration and/or eating more healthily and/or sleeping better).
*** see also below for my history of medications for what I've tried and which worked best (none were HGs)
Retaining some control/reducing severity of breakouts
I'm not sure how to prevent acne coming (I've not found any HG solution really) but salicylic acid has been very helpful to reduce the severity and frequency of breakouts.
I feel that the two products below are awesome in helping to clear up blemishes quickly.
On the spot treatments only - not recommended for all over face application
I used to use sudocrem only, which is great but only directly on the spot - slathering it all over the face may clog the skin - but benzoyl peroxide provides additional bactericidal power (die beasties, die).
BP can be drying, use with a good moisturiser and effective SPF during the day.
Unfortunately, with some forms of acne (cystic acne especially) a scar may form but I feel that the way to diminish the appearance/severity of the scar is to keep the area moist while the skin is healing. Even if a scab forms, I was recommended not to pick this but keep moisturising. This allows the skin to heal smoothly under the scab.
I still get cystic acne occasionally and the way I deal with it is to try to stop it from getting inflamed (no poking/prodding/squeezing) and BP the beast like crazy! As it is healing I also like to moisturise as much as possible.
-picking nodular/cystic acne - LEAVE ALONE (unless it has come to a head and then I will very gently apply pressure around the sides with a clean tissue or muslin cloth. Sometimes this will get the pus out and then helps the skin heal better)
-scrubs or any abrasive lotion/brush/towel etc
Why the latter?
a) They irritate the skin and can hurt
b) They increase oil production (for me)
c) I think they contribute to scarring if not used properly (I think a large amount of my scarring could have been avoided had I not used an abrasive scrubber)
I now use a BHA as my exfoliant - far less irritating and no physical damage to skin = calmer and happier skin.
If you have to use an abrasive, no matter how bad your skin is, please don't do what I did and rub away at it as hard as possible. I wanted my skin to improve so much that I rubbed until I bled...I think this strategy may have contributed to ice pick and boxcar scarring on my face. So PLEASE try not to do this, no matter the temptation!
I used to suffer from mild acne with low inflammation and then suddenly within a month my skin went mental and I became a moderate/severe acne sufferer for about 3-4 years.
Beyond the age of 21 my cystic/nodular acne had calmed to a few blackheads and the odd pustule every month or so.
This remained the case until a couple of years ago when I hit a bad bout of cysts and nodules (the inflammation was never massively severe, though it was itchy).
Current skin & regime
Over the last year my skin calmed a bit so that I was probably getting a nodule once a month.
On the other hand I get new pustules, whiteheads and blackheads everyday.
Active breakout remedy (only on blemish)
Panoxyl 2.5%(apparently discontinued)
Sudocrem (I use less under make up)
Scar healing remedy (in addition to normal regime)
Moisturise scab ~8x per day (DO NOT PICK SCAB)
A'kin cellular radiance essential oils
A'kin Lavender and Rose Night cream
(these last two can make me break out so am experimenting with replacement with own shea butter recipe)
PC Resist Anti-blemish hydrator
History of prescription medications
Last dermatological treatment which probably brought my most severe bout of acne under control about 8-9 years ago:
Oral medications that I've also tried which worked to varying degrees of success but never was an HG:
Benzoyl peroxide - varying strengths up to 10%
Acnisal daily wash (2% salicylic acid) - you can also get this without a prescription