I had cystic acne for years and was prescribed accutane, but for personal reasons chose not to take it. I researched a lot about acne and dermatology became my hyperfixation so now I have a lot of knowledge to share and my acne has improved drastically. I looked at what the causes are and tried to treat each one. Some people may have only one cause to their acne but I felt like I had better odds if I treated every cause. The things that can cause acne are: dairy (depending on the person), high glycemic diet thus irregular insulin, excess oil production from androgens (eg. testosterone), sweat, bacteria, pore clogging ingredients, stress & cortisol, poor sleep, dehydration, not cleansing, lack of moisture, pore clogging ingredients, dead skin cells and keratin, leaky gut, unhappy skin microbiome, and hormones not processed in the liver properly. So use benzoyl peroxide or hyperchlorus acid or azelaic acid or not many people realise but retinaldehyde, which is a specific type of retinoid, is antibacterial against acne causing bacteria for bacteria and sweat. Cleanse with something gentle that wont disrupt you skin barrier, I use La Roche posay caring wash. Use a kerolytic (something that regulates keratin production) for dead skin cells and hyperkeritinisation (eg. Azelaic acid), silymarin supplement or dandelion root tea to help support the liver, spearmint tea or spironolactone or winlevi (clascoterone) cream for the androgens that produce too much oil, probiotics for leaky gut, topical (applied onto the skin) probiotics for the skin microbiome, pure aloe Vera gel as a moisturiser cause it wont clog your pores, milk alternatives if youre super fed up with your acne, run your products through a pore clogging ingredients checker, and finally take care of your well-being - sleep well, eat well, work on the stressors present in your life. However dont restrict your diet just use this as new motivation to make nutritious choices. Also take a supplement with zinc, vitamin E and vitamin C for the health of my skin and drink green tea cause its an antioxidant powerhouse, and turmeric + ginger tea to calm inflammation. I have even tried taking sea moss because it is a superfood, it contains a lot of vitamins and minerals that are necessary for skin health, but dont take too much cause it has traces of lead.