Hi,
As you said you suffer from
acne vulgaris. You have taken treatment for long time. You got good response. But, again you developed acne lesions. Remember, acne is a recurring skin disease caused by multiple factors. Genetic influence may be there.
Stress,anxiety,sun exposure,oily skin,oily food, dandruff,
sleeplessness,drugs like steroids,pills,iodine..etc might exacerbate the disease.
You may take treatment for long time even after controll of disease.
Antibiotics like
minocycline or azithromycine in proper doses and
isotretinoin in low dose may be taken under observation of
dermatologist. Local application of clindamycine with adapalene gel at night with cleansing the face by antiseptic face wash like cetaphil may be considered.
Keep patience for the good result.I hope you got my answer.
Dr. Ilyas Patel MD