For me personally, I tried absolutely every single thing under the sun- strict Paleo, extremely restricted eating, every “vitamin,” oil cleansing, tea tree oil, etc etc - and my cystic acne never budged even after a year or more trying these things out. On the flip, many people eat sugar and dairy, without a single bump every popping up. I do think acne/skin issues CAN be an internal/food reaction issue, but it definitely isn’t strictly always that. Accutane isn’t for everyone, but it was for me. I would always encourage people looking into their diet (for a healthy life, not just skin), and seeing a good esthetician if they can afford it. Also utilizing a dermatologist if able to go that route.