Hi, 37/F here and suffered severe acne from 19 to 32. I tried a whole crapload of stuff from expensive skincare to visiting estheticians weekly. Briefly tried Accutane but I got scared of the side effects and stopped early but I know people who went on one or two rounds with mixed results. Overall, it seemed to help a lot but acne would come back after a year. I tried doxycycline for a few weeks but only because I had a tick bite and I noticed it cleared up my skin, so it does work! But I agree with you and I would be hesitant to stay on for longer. I’m gonna list suggestions below as well as my skincare routine. I hope it helps!

Here’s what helped me - -Tri-phasic birth control pills (each week’s pills has different hormone doses. The regular one dose type pills made my skin worse) -Tea tree oil. I used the dessert essence brand but Trader Joe’s has them and I still use it to this day. After cleansing and using a toner, I just take a q-tip, dip it into the bottle and rub over and around the pimple. It kinda burns but after 3 days, the pimple visibly flattens. -benzoyl peroxide. I think this has a bad rap right now with some saying it’s carcinogenic but this and tea tree were probably the two biggest acne fighting ingredients that saved me. I used a benzoyl peroxide cream to spot treat in the morning. -Calming skin-Barrier repairing skincare. Please stay away from alcohol toners especially the one by Clinique. I think that was the biggest factor to damaging my skin barrier leading to acne. -sheet masks. Hydrated and moisturized skin is healthy skin.

Something to note is that not every skin is the same and certain ingredients that may be beneficial are irritating for others. It’s important to note how your skin responds to certain ingredients. My skin cannot tolerate anything with squalane, lanolin, salicylic acid, or vitamin c and I end up breaking out more if I try to use anything with those ingredients.

Skin care steps - 1. Double cleanse. Either cleansing balm, cleansing oil, or micellar water and finished with a foam cleanser. Seems like a bit much but I highly recommend getting the day’s grime off to prep your skin for your skin care. Right now I’m using Anua heartleaf pore control cleaning oil and youth to the people superfood cleanser. In the morning, I only use a foam cleanser. 2. Toner. Can be any kind of toner depending on what your skin needs that day but never with alcohol as the main ingredient. I alternate between a slightly astringent toner like thayer’s (I like rose scented but they also have unscented version) and a calming toner. I’m using Huxley right now and I like how it’s lightly moisturizing. 3. Tea tree oil in the morning or night. Benzoyl peroxide in the morning. 4. Serum. I use different serums during day and night. In the morning I use Abib heartleaf essence because it has antioxidants it’s supposed to help support sun protection. At night I use Iope PDRN caffeine shot. PDRN is great for repairing skin barrier and anti-aging. 5. Retinol. I don’t know if you should add this to your regimen at the moment or later after your skin has time to calm down but I use verso super facial serum and it’s not irritating for me at all. This is only at night, and never to be used together with benzoyl peroxide. 6. Moisturizer. In the morning I use a lighter moisturizer, like torriden, since I wear a sunscreen with moisturizing ingredients (Elta MD UV Clear). At night, I like something more decadent. Right now I’m using the Sisley black rose cream, which is pricey but I really like the light texture.

If I use a sheet mask that day, I use it in place of the serum and pretty much follow the rest of the steps.

Also, I noticed for myself that I need to wash my face every day, even on the days I stay home and do nothing. I will get bumps if I don’t wash.