So I had a visit to the derm earlier this week. She said 15% of patients relapse and didn't seemed concerned that I was getting minor breakouts. She prescribed me isotrex gel, which is the topical form of isotretinoin, and asked me to use it for a month and then to come back and see her. I'm quite confident this will do the trick as my spots are really small, and only popping up around cheeks no where else. If this doesn't work I'll ask to go back on duac which I believe to best the most effective topical available. And failing that, I will consider going for a second course, but I strongly believe it sped up my hair loss and so I will think long and hard about going through another round.
In around 6 months I'll start with the derma roller to get help,with the severe scarring I have. It's like a maze has been indented on my face. Just through years of not getting treatment.