Hi Adam. Really sorry about your skin problems. I'm 25 and I've had my fair share of cystic acne too. It's so depressing. For cystic acne (as opposed to regular acne) I don't think you can really treat it from the outside. Actually, I had some of the worst cysts in my life after using topical acne products that my skin just can't tolerate. It took years for me to realize/admit that both salicylic acid and retinol make my cystic acne much worse. I'm not sure what you meant when you mentioned "allergic reactions" but I recommend using super gentle, basic products if possible. Do less, not more.

For prevention, I suggest making a small lifestyle change and see if it helps or not. Personally, I cut out dairy and meat from my diet and I definitely think it helped. I've heard dairy is bad for skin in general and both dairy and meat have a lot of hormones that can mess you up. I guess it's a little extreme but you could try no dairy for a few months and see what happens. Only problem is your body will lose its tolerance for those things. Last week I tried a few meatballs and I had a cystic acne flare-up...

Something else you could try is vitamins/supplements. I love my daily multivitamin and I know some people have had success taking zinc, garlic, vinegar, etc. Maybe do some research.Also, I always get acne in the winter when it gets really cold and dry outside. Not much you can do about that, other than moisturize and drink water. Stress is also a factor for me. After I went on medication for my anxiety I noticed an improvement in my skin.

Did you have bad side effects on accutane? I'd say follow your instincts there. It has helped a lot of people but I'm personally pretty distrustful of it.

I hope you find something that works for you.

Meg