Get your head up ! I live in the U.S. and it's really hard to get accutane because dermatologists here will have you try a bunch of other things first. The accutane didn't even work for me, and gave me nosebleeds, fainted a few times. I know how you feel. My acne is mostly big, red, angry cysts on my face so the whole world can see. Cortisone shots work great but are very expensive and can cause some headaches once u see how much money you spend.

Wash your face at least twice a day, don't pick at em or they'll get worse and leave a scar. Dealing with a scar for weeks is probably worse than a cyst that's gone in like a week. Stay away from dairy foods, processed foods, sugary foods, white things (rice, bread,pasta). Eventually our acne will go away but don't forget that many people live a worse life than us (war-torn countries, poverty).

The side effects of Accutane are vastly overrated.

It was the only thing that helped me with cysts and the only thing I can't go on it again is because I'm scared, as an adult, because my skin and intestines are more sensitive now.

You can either live with cystic acne that is obviously making you depressed (as it will--unlike the other poster, I am not going to say something stupid about how you could be living in an impoverished country, because that has nothing to do with how horrible, physically painful and socially devastating acne is) or start Accutane. Keep a journal of fatigue and depression if you have it. Take a small dose and keep track of side effects like purging of acne cysts (gets worse before it gets better).

The only other option if you are female is spironolactone or a birth control like Yaz.

ETA: Why aren't your dermatologists offering cortisone shots?

You can use 1% hydrocortisone ointment yourself--thin amount, because it thins skin--or calamine to calm angry, itchy cysts. But seriously, cortisone is great, but the effects are temporary if you are breaking out.