Hi, Welcome to HCM, You must be knowing that acne vulgaris is a multifactorial disease. Stress,anxiety,oily food,dandruff,sleeplessness, hormonal imbalance,drugs like pills,steroid ..etc may cause or exacerbate the disese. I usually treat my patient having such problem in following manner.. - to avoid suspected factors - tab azithromycine 500 mg thrice a week 24 hourly consecutively - cap isotretinoin 10 mg daily at night,if not contraindicated -clindamycine gel to apply in morning on lesions - adapalene gel to apply at night on lesions -cleanse the face with antiseptic solution like cetaphil Take treatment after consulting dermatologist. You may feel better after long time. I hope you got my answer. Thanks. Dr. Ilyas Patel MD