I am 33 years old now and I have been battling acne for 20 years now, actually I have scars on my cheeks. I have had occasional breakouts which are really cystic. After I turned 30, my acne has been always on my chin and around the mouth, my cheeks and forehead had been clear of acne. I am just wondering why on my chin and peiorally? I have tried everything Proactive,topical atbs, I have tried the tetracyclenes, erythromycin, nothing worked, even the differin gel and retin a. If they were just small breakouts, it would probably be better, but they are so big and red and painful. I am an RN in an acute hospital, and you probably know the embarassment when I face my patients and coworker. I just want my face to clear. I have read about accutane, but I don't know if that would be the last resort? I would really appreciate your input. Thank you.