i can relate to acne ,i've had it since i was a teen,i am now 65 years old,and believe me i have tried everything from a dermatologist ,all known products on the market.proactive worked for me for a while,but then it came back,and i did the 3 step treatment twice a day,regularly ,but after a few weeks or so the acme always came back,i have just gotten use to the fact that it is just something that isn't going to go away,and try and make the best of it ,when i get the in between times of clear skin.I truly believe it has something to do with our chemistry,and that anything we try will only work temporarily before returning,and when i break out i use cover up,i give up at this point in time in my life i have learned to live with it,and enjoy the time i do get a break from it.
I am also 65, female, and still being treated for cystic acne. I'm on the acne.org regimen, plus 200 milligrams of spironolactone per day. Spironolactone has been a miracle drug for me -- my face is now completely clear and I'm considering starting to slowly cut back on the benzoyl peroxide part of the acne.org plan. If your gender is male spironolactone is not recommended, because it can be feminizing, although if you don't care about that then you might give it a try.
Many internists and dermatologists don't want to prescribe it at over 100 mg, which is silly as it is a safe drug that's been around for decades. So you may have to shop around for a doctor who will titrate up your dose as needed. One more thing, you will need to get your potassium levels tested once a year (a simple blood test) if you're on a higher dose.