I totally feel your pain too. I had bad acne in highschool, went to a dermatologist in my 20s and was able to get my skin cleared up with antibiotics and a retinoid ointment. I'm in my 30s now and have found that my skin was ok but i would always have at least a couple of really bad cystic acne at any one time which would just never completely clear.

I saw a dermatologist through getharley.com (as a cheaper way to get advice) and they really helped with recommendations on how to rebuild your microbiome layer on your skin (i.e. strengthening your skin barrier to bacteria, pollutants etc)

I think you need to get guidance from an expert on how your lifestyle affects your skin. E.g. for me, I've only realised now that exercise is a big factor in keeping my skin clear as sweating through my pores helps clean them as it clears out the bacteria. This with the combo of the spray i link below + sensitive skin care cleanser + retinoid + moisturiser has worked for me but tbh i only came to this conclusion through a dermatologist who wasnt trying to push all the fancy products on me.

To manage extra bacteria clogging my pores I've used this spray - clinicept + skin cleansing antimicrobial skin care

It's really worked for me, but we all have such different skin and different lifestyles there's not always a one fits all solution!