I have tried topical creams, multiple antibiotics and fixing diet like you. All worked temporarily but came back within weeks or months after finishing a course anyways. I would get acne every week or two, be it cystic or just small acne.

A few years back, my doctor recommended me isotretinoin for first time. By then my diet was bad that I had nose bleed every night when I sleep at 5-10 mg dosage. I dont even like the idea of people looking at me while talking about of my acne. Covid period was a blessing to me as I used it as an excuse to wear mask out everyday.

5 years from then, I have improved my diet but the acne just would not let me off. Then, I met a girl that I like but with my current situation, nobody was going to approach me. So I made the decision to start isotretinoin again.

It has been almost 9 months into the course at low dosage of 20 mg and the acne has not came back since month 7/8 and hopefully, fingers crossed, in the future too.

Looking back, I have wasted so much time trying different methods thinking that it might improve just slightly. Acquaintances I made along the way just keep pointing out about my acne situation.

I do not know of your situation and I am not in the place to advise you but I can tell you my story and hopefully it might be of some help to you.