Acne - 36 yr old female

I am a 36 yr old female.  I have daily acne breakouts on my face, chest, back, and butt.  I had acne in my teens but it went away and over the last 5-6 years has got worse.  I tried the Blu-U treatment and spent thousands of dollars on products (prescription and OTC, Proactiv, etc).  Around my period, I get about 20-30 whiteheads on my chin and around my mouth.  They are extremely painful and it hurts to open my mouth.  In the past I was overweight but am in really good shape now and eat healthy.  I am not sure what is going on and have seen tons of doctor's.  Each doctor has a different prognosis.  Acne, Rosacea, Dermatitis, etc.  No pills or cremes have worked.  They recommended Accutane but I don't want to take it.  There has to be something else that I can do.   I had blood work done and hormone levels tested and everything is normal.  There has to be something else going on.   Can someone help?  I posted a pic.  

[carbear7]

I'm sorry to hear that you are going through that, i also break out pretty bad, right now it's b/c i'm pregnant and the hormones cause me to break out pretty bad, but i can't take any of my normal meds b/c of the risk to the baby...but before I got pregnant my derm started me on Differin (which i know is geared towards teens), but I am 26 and it actually worked really well.  I used that in combination with Duac...maybe talk to your doc and give it a try....only thing is  you have to stick with it, takes about a month to really see a difference, but its worth it...Oh also have you thought about laser therapy for acne? my derm office offers it but it's pretty pricey so i'm holding out, but if you truly are at the end of your rope, it might be a good option to consider...good luck in your search!!!