Chronic adult hormonal acne is really hard to get rid of. And if you're genetically prone to it or your skin doesn't shed properly then it just stays and stays. But there are ways to treat it in addition to what you're doing that might help clear it up. Although keep in mind that if you have really chronic acne then you may have to continue this for life if you want clear skin.

Spironolactone --- you may want to add this. It is mild and works as an anti-androgen. It is not a hormone which is good...it just blocks the androgen receptors in your skin.

Mocrodermabrasion --- get this at a clinic not a spa. It is a bit expensive ($100) but getting one every month or every other month helps the skin shed properly and to allow topical meds to work better.

DML lotion --- this is lighter than Cetaphil but works better in my opinion. I think Cetaphil can be a bit occlusive eventhough it says it doesn't clog pores. My skin is prone to clogging up and Cetaphil lotion is much too heavy. Just something to think about. DML lotion was developed for acne and super sensitive skin.

The other suggestion I have is to try not moisturizing after using Duac...you may be diluting its effectiveness. Try not using lotion every other night and see what happens. And then try every night. You want your skin to shed a bit. You can moisturize in the morning.

Another thing to try is no dairy. This is especially important if you have hormonal acne. The hormones naturally present in dairy seem to aggravate acne.

I found that when I got on the right hormonal treatment, I don't have to do any of the extra stuff and my skin is fine. By extra stuff I mean benzoyl peroxide, other chemicals, washing my pillowcases all the time, not touching my face, etc.

While I definitely think diet, stress, lifestyle etc. will compound an acne problem, they definitely won't cure if your hormonal problem is severe like mine. If you're doing all that stuff and your skin hasn't cleared up dramatically, I would say pull out the big guns and get on spironolactone, progesterone, or a birth control.

thanks for the feedback really appreciate yer information..Ya i dont think im able to get rid of this. I will go to the doctor early this week and discuss with him what i should do. I wonder does this mean if i went back on birth control and ever came off it again, would the same thing happen? I wondwer is there a natural way of balacing hormones? and i wonder why my hormones are being crazy???!!

Nothing may be wrong with your hormones. However, some people are just really sensitive to androgens and therefore prone to acne. All acne is hormonally based but that isn't the only way to attack the problem. You can be sensitive to androgens but utilize a treatment regime that targets acne bacteria (BP and/or antibiotics) and improves how your skin sheds (BP, microdermabrasion, retin-a, etc.) to compensate for the sensitivity. That way it doesn't matter because you are helping your skin to function well despite the androgen sensitivity. That is why your doctor prescribed Duac (BP + antibiotic).

As an adult it is tricky to figure out what will work and not work. Yes, you can go back on birth control pills and this will modulate the androgen production but if that is your way to control acne then you have to stay on them. Some people do this. The best course of action for the long term health of your body is to see if you can find a topical regime that works the way I mentioned above. This take patience and experimenting and documenting what works and what doesn't. It could be that Duac isn't working yet or isn't the best thing for you. You may need to add retin-a or add microdermabrasion to help the pores open up to better accept the Duac.

I think Spironolactone is amazing. This would be another thing to add. Ask your derm about this.