For me, changing hormones did it. I started breaking out like a teenage boy! Ugh. Anyway, I finally ended up at the dermatologist, and long story short, ended up on a 6-month course of Accutane. My skin is beautiful again! Hopefully you don't have to resort to Accutane, because it is a difficult medication to be on (although it does provide a permanent solution to acne), but a dermatologist wouldn't be a bad first step. I only say this because I spent a lot of money (before going to the derm) on drugstore remedies. All that did was aggravate my skin and make the problem even worse! Plus it cost a lot. Even if a cleanser or lotion or mask only costs $10, if you end up buying several different kinds, there you are $50 later with more acne than ever, and a cabinet full of stuff you'll never use. :-/ My vote is, see the professionals first, for what it's worth!