So the brand Nizoral dandruff shampoo uses ketonaczole. Now this is different from your standard anti dandruff shampoo. Head and shoulders and most other brands use something different. This will not work for bacterial and cystic acne. Only for fungal acne. If it's on your shoulders, simply just rub some shampoo on your shoulders and let it sit for a little then rinse off. Now me personally I get dandruff sometimes so I use this cuz it works way better than any others. But I don't think your supposed to use this daily for long periods kf.time.unless you have severe dandruff. So it stays in the shower and I use it sporadically. What I also do is whenever I wash my hair, probably like 2/3 times a week depending on how bad I sweat daily. I also take this and rub it on my face, shoulders and feet as a precautionary measure but when I take breaks from using it I also use it on my feet face and shoulder like 2x a week. Yes it is a lot more expensive than any other shampoo. This is just one of those little hidden things where if youve tried everything for your acne, this could possibly be the answer. Do your research.