What seems to work for me
I am almost 20, and I have been struggling for acne for about 6 years now. I have tried topical ointments, minocycline antiobiotics, benzoyl peroxide washes, etc. All of them seemed to work initially but lose their effectiveness over time.
What I've been doing for the last ~4-5 months is using benzoyl peroxide creams, specifically Panoxyl 5 Aquagel. It is a water-based gel that I apply to my face and leave on overnight. I tried BP before in a facewash form, but it didn't seem to work, so I think this stuff works because it stays on your face to fight the acne all the time.
Since I started it 4 months ago, my face has cleared up a lot. I basically have no more acne, except for faint marks that are hardly visible. I'm not sure, but I think these might be just old pimples that are slowly fading, rather than new ones constantly replacing old ones. I know when I first started noticing how clear my skin was, it was the greatest feeling in the world to realize I'm finally winning this battle, because my acne caused me so much depression as I'm sure it has for all of you as well.
What I'm really not sure about is whether or not this therapy I'm trying did the job, or whether I'm just old enough now that I've grown out of the problem.
Before you go to an intensive drug like Accutane, I have this management theory which might help get rid of your acne.:
1. Modify your diet to make sure you are eating healthy. Simply follow the plan which is recommended by dieticians, and stay away from any unsupported "miracle acne curing" diets that you see sometimes.
2. Go see your doctor about a prescription for minocycline or another oral antibiotic.
3. While taking this antibiotic, also go out and purchase a Benzoyl Peroxide gel to apply to your face twice a day (morning and night). That way you will be attacking your acne from two different angles. Remember I personally found that the gels worked better that you leave on your face, instead of using the washes. I know for some people benzoyl peroxide will dry their face out considerably. It did for me, but after about two to three weeks of dried out, peeling skin, my skin adjusted to the medication. So hang in there! The fact that it is drying your skin out means that you are preventing the sebum/oil from building up on your face which contributes to acne. Dry is good!
4. Wash your face with a mild scent-free soap in the morning and evening, and after any greasy meals or being in a greasy environment. Remember: Do this BEFORE applying any benzoyl peroxide cream, so as not to wash the cream off.
5. Try to avoid touching your face.
6. Think positively!
That's about all for now. Note that if you have severe acne, or you want a sure-fire approach, see a dermatologist. This is just my idea, and though I think it is a good approach and should work, I don't want to condone it to anyone because it might not work for you. I'd feel bad to cause anyone any more time enduring psychological damage from acne, when you could have been trying something else.