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What should I do regarding this acne?

I've had it for 19 years, and it's usually moderate, very occasionally mild. Lately it keeps flaring up over and over and nothing seems to bring it back to a reasonable state. (Hey, I'm not expecting clear skin, just skin that's a little better than this.)

These pictures don't really do much justice since the pics of my chin, other cheek and forehead didn't come out very well. I'll try to take some others when I get a chance. As you can see, it's the normal papules and some whiteheads, but it's my forehead and chin that are really screwed up.

I've tried it all. You name it, I've used it. O-T-C products, high end lines like Murad, BCPs, all px retinoids, oral and topical antibiotics, etc., etc.

My derm this week turned me down for even a tiny 5 mg dose of Accutane. I was willing to go that low because someone I know had mild acne, took 5 mg/day and it cleared. All I wanted was a chance to try it, but because I take medication for depression and anxiety, my ultra-conservative psych stepped in and shot it down with my dermatologist. Other derms wouldn't even consider letting me try a small dose.

Any recs for me? I know this is very mild compared to what many of you suffer, but it still itches, is sore and is just so stubborn.

Keep in mind - these pics are not the best I could come up with. Mostly you'll just see reddish marks from healed pimples and a cluster of them around my ear:




Thanks for any advice...

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Hmm, have you considered using something natural to dry them out? 50% Apple Cider Vinegar and 50% water used as a toner may do the trick as it's so mild. You could also use something to calm the skin after wards like jojoba oil or aloe vera. I think cosmetic products would make it worse, which is not really what you want to do since your skin is looking really clear and healthy.

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That is one thing I haven't tried because vinegar's odor makes me really nauseous, as in, I can't even tolerate it on my skin for a minute. Weird, I know.

I've been using some clay masks that seem to dry it out a bit, but then they're still there. I'm also doing light therapy with a Baby Quasar that so far hasn't helped.

Maybe I should try a salicylic peel again on the area and see if it dries it out more...

Thanks for responding. :)

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