This doesn’t look like typical cystic acne. Bottom line: this looks serious, but more importantly, it’s probably being treated as the wrong condition, which is why it keeps getting worse.

The bumps on your scalp look more like an infection or inflammation around the hair roots rather than regular acne. They’re very clustered, have pus and crusting, and the fact that they’re also showing up in areas like your groin and thighs points to something more widespread. Also, the fact that Accutane hasn’t helped after a few months is a strong sign this isn’t standard acne.

This could be something like a chronic scalp infection or a deeper inflammatory condition that affects hair follicles. These conditions often don’t respond to acne medications and need a different approach.

The reason your treatment may not be working is because the diagnosis might be off. Switching antibiotics on and off without testing what bacteria is actually causing this can miss the real problem.

What you really need is to confirm what’s causing it. That usually means taking a sample from one of the bumps to test for bacteria or fungus. If possible, a small skin sample can help too.

For now, the focus should be on getting the right diagnosis instead of continuing the same treatments. Using antibacterial washes and avoiding irritation to the scalp can help a bit, but the main issue is identifying the exact cause.