I never had too bad of acne until I tried a prohormone at 35 yo- my back had CYSTS all over it- would not take my shirt off for a whole summer or more. Tried every OTC and antibiotic (my mom's b/f was dermatologist who I consulted with).
Accutane was the BEST thing I ever did- don't go crazy on doses, and yes, it has side effects (noticeably dry skin/nose/lips) but the best thing I ever did. I have done real Roche accutane and some from sponsors- sponsors stuff is great. Just don't expect miracles overnight- maybe 1 - 2 months at 60mg ED then 20mg ED or EOD.
If you have the nasty, puss filled acne on your back, you'll want to use accutane. No soaps, etc will work.
I had acne off and on for 10 years(26 now) to this day if i am not tan can see the scars on my back. i did accutane for 7 months 80mg every day, poof gone maby get one on 2 a month and if i do they are 1/3 the size good rule of thumb is 1mg per kg of body weight but my hair has not been the same did not lose any (my sis did on accutane) but eyerbows and head hair is a lot more coarse not as oily, and i get a mor ingrown hairs but would i do it again hell yes in a second
Now that I've matured since my acne/backne, and more prone to the cystic, plus was more an adolecent thing, and hereditary too from dad side, yuck. All the talk about accutane, I will always be grateful for the ol yellow softgel roche LOL I cant say I will miss the needing a tube of carmex a day cuz my lips looked like overmicrowaved hot dogs all blistered and peeled or the crazy technicolor skin tones either.... occasionally do still get the night time eye sensitivity to light, and shit its been almost 15 years ago LOL Still, cant be beat...
Im also a huge fan of accutane. I have scars from years of cystic backne and accutane was the saving grace. I still get acne but they are much smaller and way less. I didnt really get any sides except dry lips and wasnt even that bad. Ive even thought about doing it for another 6 month cycle to wipe it out completely and hopefully forever.
as others have stated above: accutane. it's a miracle. watch out for liver toxicity, however. When i had it prescribed from the doc, i was required to give blood samples each month for 6 months for them to check liver values. I was prescribed 40mg 2x/day. Everything was fine through my course. Two years later, it came back. I couldn't afford the stuff then, (it's like $400 for a 30 day supply), or now...so i use the stuff that the sponsors have (which works just as well).
You'll also need to take it with a HIGH FAT meal to get good absorption. It's a retinoid, which are compounds related to vitamin A. They are all virtually insoluble in water, so you won't absorb much without a good oil base. Mix the solution into a protein shake with a few tablespoons of olive oil and you'll get great results. If you have it in pill/capsule form, then make sure you take it with some oily foods.
For the side effects, like dry lips, you'll want to keep some neosporin or vaseline handy. Chap-stick won't work too well, (at least in my experience), and seems to make the lips even dryer. Neosporin those up each night, and possibly a little in your nostrils if you start getting a dry nasal passage.
Accutane is the only thing that helped me. 40mg twice daily for 5 months. I haven't gotten back zits in years because of it, and I used to get it really badly. If Accutane isn't an option, Panoxyl soap (over the counter) helps a little bit. It's a benzoyl peroxide soap to use in the shower.