I have struggled with acne since 1974. It is genetic, several family members have also struggled trying to resolve chronic acne. My mother's cystic acne was chronic and terribly scarring. She was a nurse and had access to treatments had underwent multiple types of treatment in the 50's including heat lamp treatments. Nothing worked completely until she went on Accutane in her 40's and then had a chemical peel. She still would get deep black heads and inflammation, but so much better. My acne was small inflamed, occasional a large inflammation and relentless until I was 18 when it became cystic. From the time I was 13 to 18 I was on multiple medications topical retinols and antibiotic pills. I was minimally scared, until the cystic acne and that created shallow depression areas in my skin, on my chin and cheeks. When I had my own insurance, I began to search a solution. Underwent deep chemical peel and Accutane. Accutane scarred my skin a bit as it broke me out before it cleared my skin. I still had blackheads and closed comedones, occasional small break-outs but I am 50 years old. I was mistakenly convinced my skin would never break out after menopause. It has helped considerably being post menopausal, not entirely. I also found Omega 3 chewables considerable reduces swelling in acne and keeps me fairly clear. I have a prescription for Atralin and Acanya. Both help but I cannot say enough about Omega to keep swelling down. Without inflammation acne is much easier to cover. I use a mild wash Cetaphil I started using Cetaphil products when my Dr. suggested it after the chemical peel. Astringents and strong washes seemed to make my acne worse. I am derma rolling now and looking at solutions to clear large pores from chronic blackheads and icepick scars on the cheeks by my nose. I am looking at ways to really clear blackheads and blocked pores. My heart goes out to anyone who has this battle. It is physically painful something that is not commonly acknowledged. Cysts are crazy painful and take forever to heal. My mother always said having our oily skin would minimize wrinkles and that is true. My skin has been years of tears and prayers.