I started having bad case of acne when I was 18 y.o. This was healed by using Retin A and at least twice a month facial. I was acne free for almost three years then it came back when I was 21 years old. Went back to Retin A and it seemed that its magic disappeared on me. Frequent facials help a little bit but I continued with Retin A till I was 36 years old. It seemed that my cystic acne comes and goes and I'm now 42 y.o. and last June after almost acne free for more than a year, some of the cystic acne came back on my face. I have been using lactic acid and salycilic acid peels alternately which helps a little bit but occasional breakouts still happen. I'm just praying and wishing that I will not have this anymore as I get older if this is more of genetics or hormonal. I also tried low sugar diet, exercise regularly to help clear these buggers. Recently, I discovered saline wash and tea tree oli through online research. Both possess antibacterial properties that clear and fight blemishes. Saline is compatible with blood and I use this to iirigate wound dressings of my patients and it works wonders. Tea tree oil is taken from the leaves of Melaleuca altemifolia and it grows in New South Wales Australia. Anyway, both of these therapies have help me in the last few days and I will update you guys with my present regimen.