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.