Hi, I can understand your concern for severe acne. But,you may be knowing that acne vulgaris is a relapsing skin disease with different forms like pustular,conglobate,cystic etc... Patience is needed to get good result. After few months of continuous treatment you might get good result. Along with low dose of isotroin 5 mg, (if you wish to conceive,kindly avoid isotroin ), you may take antibiotic like minocycline or azithromycine for long time. Benzoyl peroxide 2.5% gel may be applied on the lesions at night and clindamycine gel in morning. Cleansing the face with antiseptic face wash may be advised.Triggering factors like stress, sleeplessness, travelling,hormonal imbalance,oily food,dandruff ..etc should be kept in mind. I hope this would be helpful. Thanks.. Dr. Ilyas Patel MD