I can photoshop your photo for you for $2.00
I used to have the worst acne. I was using topical retin A for years in the mid 90s, and it didn't help a bit. Then they put me on minocyclin or minocyn or whatever it was called. It did nothing but make me poop my eyes out and get nauseous every waking hour. I also got UV treatments and whatever else was available back then.
Finally, I had an appointment with the same dermatologist as a check up, but he cancelled and they redirected my appointment to an old old crotchety doctor. He said, "So you're using all of these meds and topical solutions and special soaps and nothing has worked? Why don't you throw it all away and buy some Dial soap and use nothing else." I said, "but it will give me dry flaky skin." and he was like, "Yeah? what do you want, acne or dry skin?"
So I tried it. Dial soap. Non-scented, white, plain Dial bar soap. It worked. Within weeks. 10 years later, I still get the occasional zit, but it stopped the severe stuff. And, yeah, my face is dry still, but whatever. I can use moisurizer on that.
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