Hi, Acne vulgaris is a multifactorial skin disease characterised by comedones, inflammatory papules, pustules nodules and cystic. You are having nodulocystic acne. It is a relapsing disease and triggered by many factors like stress,anxiety,hormonal imbalance,sun exposure,travelling, sleeplessness and some drugs like INH,steroids,pills..Genetic influence may be there.I can understand your concern for acne. But,you have to take long term treatment and to keep patience for the good result. You consult dermatologist and have perfect treatment. Still,I would suggest following tips ... - antibiotic like azithromycine or minocycline - isotretinoin in low dose - dapsone is effective in nodulocystic acne - intracystic steroid injection might improve the lesions - clindamycine gel or benzoyl peroxide 2.5% gel to apply on lesions at night - cleansing the face with antiseptic face wash like cetaphil You consult dermatologist and have proper treatment. I hope this would help you. Thanks. Dr. Ilyas Patel MD