Hello, Welcome to healthcare magic. I understand your concern regarding cystic acne. I advise you to discuss with your doctor about starting oral Isotretinoin. This drug works very well for cystic acne. You will need to monitor liver function tests and serum lipids while on this drug. In general, it is quite well tolerated by most of the patients. YOu may experience dryness of skin and chapping of lips while on this drug, which can be managed using emollients. Avoid creams on your face. Avoid oil on your scalp. Diet is important. Avoid milk and milk products like cheese, chocolates, sweets, sugary foods and drinks. Eat a lot of fruits rich in vitamin A (anything with lot of color). Hope this helps you. Take care.