I am in the exact same boat! Recurring cystic acne that come back if I stop taking spironolactone and doxycycline. I’m also using differin gel and that’s been helping too with more surface level stuff! I’ve been considering accutane as well im a little hesitant as I know it can have some side effects and doesn’t necessarily guarantee you won’t have acne again.

Literally best decision I ever made was to start accutane. Highly recommend. About to finish in a month and so happy with the results. Side effects were moderate at worst, and even then it was only for bits of time and then they went away

Accutane was the only thing that helped my severe cystic acne. I tried all the creams, pills, facial treatments, etc. and nothing worked. Accutane took a toll on me physically, and it sucks to go get blood tests every month, but it was SOOO worth it. I would 100% recommend it to anybody struggling with stubborn painful acne. I went from not leaving the house (even to go to a gas station) without a full face of foundation, concealer and powders, to going completely bare faced and not feeling ashamed of my skin!