Acne either off cycle or on can be caused by either a bacteria or a fungus clogging the pore along with excess sebum from your sebaceous glands that also grow with AAS use. 2 ways to combat this that us worked for me. Use nizoral shampoo which has an anti fungal called ketoconazole in it. Use this as a body wash. I also use one of those long brushes with the plastic bristles to scrub your back. This is the key here, you have to exfoliate the skin to clear the pores and let the anti fungal get down to where it needs to work. I do this every time I shower and just made it a part of my normal routine and this has cleared up any acne on or off cycle. Also make sure you shower pretty soon after working out or sweating. Last thing is make sure on cycle and during pct your estro is in check. Hormones are fluctuating just like they did when your balls dropped and you got acne on your face. Keep the estro in check and level and you lessen the chances for acne. Blood work is your guide to this. Everything else is just guess work without bloods.

A good dose of zinc actually helps. Anything topical tends not to solve the problem, but can help temporarily. Usually when dht levels rise it increases acne in some people to varying degrees. Zinc helps cancel the acne affect the dht causes or dht's affect on the skin I should say. It may make u break out worse at first but keep at it and Accutane also tends to make you break out real bad when u very first take it. Then your skin peels among a host of other side effects. But it does work pretty good.

Do the accutane, you will be a new man. Keep your liver clean! Get some udca and use 1gr a day throughout your treatment. Stay away from orals and preferably tren so you don't over tax your liver and you will be fine. Drink lots of water and stock up on some Carmex chapstick. The doctor will monitor your bloodwork and will adjust your dose.
From what I'm reading you are describing none of these other things will work for you. Nothing else worked for me, my back had 4-5 zits on every square inch of it. After a 8 month treatment of 60mg a day my skin is PERFECT! I get few little zits here and there but that's it. I'd does take a long time to start working and at first it gets worse, but once it starts working... it really works!
After you done with the treatment continue to keep your liver clean, milk thistle, turmeric, vitamin c, lots of water. Clean liver=clear skin.

On my 13th week of a 5 month accutane course now, have had the same problem with spots around my shoulders that have been there since highschool over 10 years and I broke out badly on my chest during a tren ace/prop cycle which lead me to jumping on the course I'm on now... AND IT'S ALL CLEARED UP!! I'd recommend jumping on the accutane.. But be patient! The first couple of weeks was rough. Had been given allsorts of antibiotics and bullshit for the shoulder acne before and nothing's worked... Until now! I'd advise you to drink as much water as you can though side effects are pretty much feeling like a prune :))

https://www.eroids.com/forum/general/general-talk/how-i-beat-acne

When I'm at the end of my cycles i tend to start to get acne pretty bad on my traps. My wife like to make this stuff she got from a website.
Its as follows:
few tsps of nutmeg powder with a few drops of water.
stir it up to make a paste and apply it to the area you want. keep on for at least 20 mins then wash off, you repeat this a couple times a day and it goes away REALLY fast (for me 2 days) better than using accutane thats for sure!

I use vitamin C, I buy the raw powder here http://www.dudadiesel.com/search.php?query=ascorbic

just mix it with water it will burn a little the first few times.

https://www.eroids.com/forum/steroids-qa/anabolic-steroids/found-the-ult...

a few members on here use the same cream they use on dogs that have dry elbows, some kind of potent anti fungal type stuff, ill try and dig it up, ill get back to you.

nizoral shampoo, lather that shit on, leave it on for 5 minutes, rinse and repeat, broad spectrum anit biotics, anti oxidants like vitamin e and c, also sea salt, pour it into a warm bath, soak in the salt bath for half hour a day, let it dry for ten minutes, get your misses to massage a thin layer of unfragranced natural sorbeline cream all over the areas, the worst thing you can do is dry it out to much because the oil glands start over working to produce more oil due to the dryness, diet, stay away from fried fatty foods, also bloods, could be as simple as a hormone imbalance, could just be an ai adjustment.

Accutane is the only thing my dermotoligist prescribed that works. It shrinks your oil glands. I was prescribed 40mg a day this was way to high of a dose it got ride of the acne but my skin and lips dried up bad. I take a the 40mg once a week and it works fine no side effects. It's a government controlled product so you have to go to a lab to get you cholesterol checked then take the blood work to your derm and then he decides what to do every month. It has high suiside rate and baby that are born on accutane look like cone head so be careful. But I works

This may sound weird but when I was in high school one of the brothers had serious acne. His dermatologist told him to eat 3 bananas a day and within 6wks his acne was all but gone

I was on Accutane starting in March, Doctor supervised. I only made it about 3/4 to the total goal of mg's i needed. My liver enzymes went up too high, and I developed random bouts of nausea. That being said, even the amount I did manage to take greatly reduced my acne. 3 months later I'm still having some trouble with nausea, but my liver scores have settled. It was a rough process for me, but I would still do it all over again.
Hope that helps.

Just use the accutane if through a doctor. You'll love the results after you've been on a couple months and it's probably going to be permanent if your derm does it correctly. I wish I'd done it sooner

Found an old thread here with a review. https://www.eroids.com/forum/steroids-qa/steroid-cycles/accutane-experie...

Ive had serious scalp acne and occasional cystic acnes on my face and chest on cycle for quite awhile. Tried antibiotics, accutane, benzoyl peroxide...etc and other stuff like nizoral shampoo but they only help a bit. Recently I just started trying finasteride because I read that DHT could also induce acne. And my skin is mostly clear only after a couple days. Typically my scalp is constantly swelling and red and this is also solved. Finasteride has some nasty sides so you might want to do more research on it if interested.

If your dermatologist thinks accutane is what is needed, then I'd go with the Doctors opinion bro, no real advice to give except listen to your doctor. Lesser cases of course there's things to help but yours sounds serious, so listen to doc and hope it clears it up for you brother

Good Luck

accutane will likely be the only thing that can reduce your poor size/and or excess sebum production. Nothing else IMO will address the cause.