Ask a doc for erythromycin.
I'm 34. I had accutane treatment when I was 25. Before that I'd get big, fat cystic acne in different spots, esp. my forehead. After accutane, my forehead has been clear for the most part. The benefits of accutane lasted for a few years, but around a year ago I started getting the cystic/nodular stuff on my cheeks, around my nose.
I want to get another course of accutane but have to wait a few months. The tetracyclene antibiotics did ok for a while, but then stopped doing anything.
Long story short, the best thing for me, right now, is erythromycin. Lack of sleep is my biggest problem, and with the erythromycin, I have mild acne. (I don't want ANY.) But even when I get nodules or cysts after a crappy night's sleep, the erythromycin helps a lot (after a couple of days).