I have done and tried about everything too (I started getting bad acne at 18 and I am now 31) and can tell you what worked for me.
- I finally took accutane in my early twenties (after years of Dr visits and various acne prescriptions) and it obliterated my cystic acne (on my face and my back)
- I was still breaking out with non cystic acne (only on my face thankfully) so I got on the Biomedic skincare line (by La Roche Posay) and got some of their salicylic peels done in a dr's office. While it did do great things for my face the peels were expensive to do and the peel process was not pretty to go through (took 2-3 days of heavy peeling). I did keep using the medicated Biomedic wash though.
- Again my acne creeped up again after a year of no peels. I went to the doctor and had Retin A micro prescribed for the acne. My prescription sat unopened for a a few months as I tried Retin A in the past and hated the side effects. I would always quit after a week or two because I could not stand the horrible side effects.
- Fast forward a few months later I decided to give my Retin A micro a real shot. This time I got some Obagi blender cream (which has hydroquinone in it) for lightening too. The blender cream is designed to be mixed with Retin A products. I also switched to Toleraine face cleanser (made by La Roche Posay) as I could no longer use my medicated washes. I started off with my application once every three nights for a couple of weeks, then every two nights, and so on. After 2 months of breakouts and red itchy skin my skin started to get better. I quit using the blender after 3 months (you are not supposed to use long term). It has been a full 4 months now and my skin is looking 80% better. Just some old marks and a couple of bleakheads, not a single zit. Also my DH's aunt is a derm and she suggested putting moisturizer on my skin 20 minutes prior to the Retin A to keep the irritation down. So I use the Toleraine moisturizing fluid prior to Retin A. I don't even use a pea size amount of Retin A. Just enough to barely cover my face
- My DH's aunt also mentioned there is a newer product called Refissa that is a .05% tretinoin cream that is even more gentle than Retin A micro because it is fragrance free and emollient based. I might look into it when I run out of my Retin A Micro.
Sorry to go on about Retin A, but I never gave it a real shot in the past and found it to be worth the crappy first couple of months.