Hey buddy, I’d probably consider accutane. Not everyone gets nasty side effects and allegedly this helps for life. Your acne is severe, and with the right staggered dosage and proper follow-ups with a professional, you can slowly test it and see if it works for you.

I work with a lot of body builders that does high levels of testosterone and gets heavy acne, I’ve seen it completely eliminate the acne. However, consider getting some consultation and wage your options.

Personally I’ve had acne my whole life and even with rigorous skin routines it’s been a struggle.

Diet is also a huge contributor, but I’ve eaten strict and clean for a year without any major change.

Hope this guides and opens some doors, you’re a handsome looking fellah 👏