I began treating my acne almost exactly a year ago today. I've had mild/moderate acne most of my life, but things started getting worse around 16. By 17, I developed moderate/severe acne, with many cysts on my chest, back and shoulders. But I actually didn't even care about it enough to treat it at the time. I only went to my derm to get my hyperhidrosis treated, but she, to my annoyance at the time, seemed much more concerned with my acne. Slowly, my focus shifted from my hyperhidrosis (which doesn't even bother me any more) to my acne.

I was prescribed benzoyl peroxide, clindamycin, and doxycycline. I opted out of taking the oral antibiotic due to fear of side effects and generally just not liking taking medication. I achieved pretty incredible results just from using the BP and topical antibiotic, even though I used them pretty irregularly and not in the best ways. I began treatment in April of 2014, and by prom of May that year, I only had one active pimple, albeit it was a decently sized one beneath my lip. After that, I struggled with a few residual cysts on my back every once in a while, but once I tightened up my regimen and knew more about the best ways to use the topicals, those cysts also went away.

I enjoyed 4 months of practically perfect skin from late May to late September, aside from the left over scarring. I received compliments from all of my friends about how I had the best skin out of all of them. However, at the end of September, I experienced a pretty bad breakout, not in number of lesions, but in severity of the lesions. I had two of the biggest cysts ever on my back and shoulder, although they went away quickly. The ones that bothered me the most were on my face. I broke out in really inflamed, really painful pustules around my mouth that took about a week and a half to go away, and once they did, they left scars. I also broke out in about 2 cysts on my forehead which also left some scars. This really bothered me because I never really got cysts on my forehead before, and when I did, they never scarred. At the time of the breakout, I had stopped using clindamycin and had stopped taking zinc, niacinamide, and copper because I didn't really think I needed them and I was just experimenting. I had also started using a salicylic acid product, so I thought that an ingredient in the product may have caused an outbreak.

After the cysts cleared and I learned to deal with the scars on my forehead, I began the topical antibiotic again and started taking the supplements as often as I remembered too. I also cut out the salicylic acid product just in case, and also started using the acne.org BP in the proper amount instead of small amounts of the Neutrogena BP. Everything was all well and good, although I did experience more (mild) pustules around my nose than usual. Until around Christmas.

At the beginning of December, I developed 3 new cysts on my forehead, all three of which literally took until the beginning of January to clear. When they cleared, they left three of the biggest scars I have today. These scars devastated me because I care a lot about my appearance, but I figured, "You've only been using the acne.org regimen for about two months, and some people say it takes about 4 months to start working on more severe acne. This was probably the last breakout you'll have." And things had been good since then. Lo and behold, starting in the middle of March, I started breaking out around my mouth and jaw in nodules and cysts. They weren't "insanely big" or anything, but they were significant, and the ones above my lip tend to leave icepick scars. Those took about until the beginning of this month, April, to fully go away. Just when they did, I started getting breakouts on my forehead of pustules, which is really weird because I haven't had a pustule on my forehead in a year. "No big deal," I thought, "These probably won't leave any permanent damage." Of course, just this week, I developed a bigger lesion on my forehead. I don't know if I'd call it a cyst, but it's definitely on the bigger side and it's got a weird texture and look to it. It's almost gone now, but I feel another bump forming on my forehead, so I'm super scared that I'm going to end up with more scars.

I know there's some debate about whether or not the regimen works for cystic acne, but I find it strange that my back, which was more severe than my face in the first place, would be 100% clear for 7 months, but my face is still breaking out. Obviously the regimen has the potential to clear cystic acne because that's what it did for my back, but I was wondering if anyone had any advice on what they did to completely get rid of cysts on their face while on the regimen.

TL;DR

I have been treating moderate/severe acne for a year, got serious about it seven months ago with acne.org regimen. Back has been 100% clear since, but my chin, mouth, and forehead occasionally break out in scarring cysts. Need advice.