Some starter information: I've had acne since before I was 15 and it got worse with age, and it's now worse than ever. My acne is a constant. Even when nothing's bursting or hurting or itching like crazy, I'm able to feel clusters forming deep under the skin. My menstrual cycle used to have no effect on it, or at max just as much as anything else (allergies, stress, sweating...), and when a derm put me on birth control it didn't help at all. But I got new (painful, itchy) cluster breakouts before my last period and now, weeks later, they seem to be getting worse instead of better. The soreness and itchiness are driving me crazy.

I have consistently bad luck with medical care. I've tried going to dermatologists several times; none of them ever, ever prescribed a moisturizer with the pricey soap-and-acid combos they decided on; none of them ever gave me a detailed prognosis like identifying my type(s) of acne; none of them ever ran tests to determine the cause (bacterial, fungal, etc.) of my acne. They don't really listen and sometimes they won't even take a good look - the last doctor I saw 2 months ago was okay with putting me on Accutane without coming within 5 feet of me, even after I let her know my mom had identical breakouts throughout most of her life and got a drug-induced liver damage that landed her in the hospital within a week of taking Accutane.

For this reason, I'd feel safer going through low- or no-side effect over-the-counter treatments before I resort to Accutane. I'd like to ask for opinions on my acne type(s) and what to use. There's a pic of my forehead for comparison - weirdly enough I've always had an inversed T-zone, with my nose and forehead being pretty clear.