yeah, acne is such a pain, and such a debated topic. But is it acne? Acne vulgaris? Or the 'ole' garden variety pimples.
Once it was thought that pimples were related to hygiene, then to diet, now to hormones...but, it has recently been understood that high levels of sugar intake affect your hormone output...maybe there is a relationship in some people.
For me, as for others, it is hormonal....Acutaine worked well for my brothers back, those disfiguring purple lumps, and high levels of vitamin A worked for me when I was in my twenties..but not anymore...now I take high levels of Estrogen. (screw the breast cancer...just give me beautiful skin lol)
Testosterone is definitely a culprit in some, as anyone going through a sex change will tell you. I've been on it for menopause and behold, those zits that sit below the surface of the skin and emit high levels of pain, the swollen throbbing ones...no one knows they're there but you....until you dare to touch one and then they turn purple and leave pits (I've been able to resist!)
For these I have Clindamycin, a strong anti-bacterial cream,available only through a prescription. It was originally my sons, but, I purloined it as it immediately takes the swelling out of these types of zits.
Then there are blackheads, whiteheads, and those ordinary "monthly cycle" pimples, and I believe guys get a monthly cycle of some kind, as my sons pimples arrive as suddenly as a crowd at a Dairy Queen, hang around for a bit and depart leaving him unsullied.
You need to ask your doctor for a referral to a specialist. There are too many different factors to take into consideration. My mom and dad had perfect skin and 3 of their 5 kids had terrible, disfiguring acne. Apparently some people have a mutation on a chromosome that causes them to be extremely sensitive to normal levels of testosterone.
One of my sisters who escaped the teen years with perfect skin now has an awfully bad case of acne vulgaris on her back, and she's in her 60's
gawd, will it never end? good luck!