Hello. I have gone through your question and understand your concern. Acne can be caused due to various factors. Root cause of acne in the age group of twenties could be hormonal imbalance. Undergo a few basic tests like thyroid profile, ultrasound abdomen and pelvis. Your problems appear to be deep, painful, comedogenic, inflamed. Stop washing your face 6 times a day as it will only strip out moisture from your skin making it produce more oil thereby causing acne. Use a mild face wash like Sebamed clear face antibacterial cleansing foam (available on most pharmacies) thrice a day and use a mild moisturizer like Acnemoist (mild moisturizer for acne prone skin) once a daily at bed time to prevent dryness. Start with Lacne gel (a combination of adapalene and clindamycin) local application daily every evening applying a thin layer over the affected area for 15 days. Followed by regular use of sunscreen of SPF 30 every morning, as skin get sensitive with use of adaplene. Lastly, remove all the makeup once your home and let your skin breath as blocked pores causes problem to aggravate. After 15 days of above treatment and medical test, lets us know here at HCM. Once acne subside acne scars can be treated. Hope your concern is answered. Thank you.