Hi, It seems that you have acne vulgaris from long time. There may be genetic tendency. Your skin might be oily. You may be having seborrhoea. Some factors like stress,anxiety,tension,insomnia,sun exposure,oily food,drugs like steroid,INH and iodine..etc might exacerbate the disease. Take cap minocycline 50 mg in morning and cap isotretinoin 10 mg at night for few months or till good result. Apply adapalene gel at night and clindamycine gel in morning on the lesions. Cleanse the face with antiseptic like cetaphil liq thrice a day. Avoid all suggested factors. You may become alright. I hope you got my answer. Thanks. Dr. Ilyas Patel MD