Hello,Hello , Welcome Before I discuss any thing Just rule out drug history. Because type acne you are explaining here may related to some medicine like medicine for seizure, steroids, epilipsy or something else so if you taking any medicine since long time kindly mention full history about it. If not then lets discuss further. 1st few points you should keep in mind 1. Don’t use hair oil and any sticky cream on face. 2. avoid oily food , chocolate , milk products 3. avoid dust, use sunscreen( above 30 SPF) 4.Any cream don’t rub it on face 5. Don t use any steroid creams 6.Continue treatment atleast 1 month 7. Facewash or soaps are not treatment and not much use full 8. Don,t touch acne and avoid pressing it. For treatment 1.Clindamycine ( CLINTOP, FACECLIN, CLEAR GEL) - this is more of preventive and curative so I tell patients to use it all over face in the morning 2.Adapalene gel ( adalene, defferine,)– I tell to use it over acne in the night. 3.Tab doxy 100 mg once in a day. Now as you are saying that acne is very severe so treatment plan can be changed . You can switch to Isotretinoin 20 mg instead of tab doxy but that need proper guidance by doctor and blood checkups. One condition PCOD which is ovary related problem in which acne is main symptom, If no treatment is responding then have to check out this too. Irregular menstruation, facial hair, obesity also feature along with acne in this condition. Blood FSH, LH, ANDROGEN are test to rule out PCOD. But dont jump to this initially 1st start with treatment plan mentioned above continue it for 1 month and follow up again. If response is not seen then we can do further evaluation.