I finally gave in and tried low dose accutane and was amazed how well it cleared up my skin and I noticed no negative side effects at all, no chapped lips. Not the advice you're looking for since you mention you don't want to take accutane. I always developed oily skin and ance when taking gear but a few years ago started getting very large deep cycts i guess they are called. First time was my middle chest area, I thought it was a serious condition like an infection the thing was so large and deep, finally came to a head and it was nasty nasty. From then on id get more, on my chest, then on my forehead. I tried the typical ways to prevent acne, shower often, always cleaning my face, tried a few over the counter ance face and body washes. I tried benzoyl peroxide which seemed to ruin my pillow cases. Since i was a kid i always had dry skin and had dandruff on my head and even my eyebrows, winters were worse so I always use a dundruff shampoo daily, switch between Selsun Blue and Ketoconazole. I would also develop patchy looking skin after tanning, I would get a really great nice dark tan but then it would fade and look blotchy and the dandruff shampoo used as a body wash helped a lot with that. I never had bad acne on my back except the occasional single big pimple. Then about a year ago I took part of a promo and figured it was a good opportunity to try accutane. I did a lot of reading about it and saw low dose accutane may work without the negative side effects. I took one tab a day and within 2 weeks i noticed my skin getting clearer, it just got better from there. Like I said i did not notice any negative side effects. For me i don't think its works permanently, meaning so far it seems to only work while I'm taking it. I first used it for 100 days and it worked great, then i stopped and the ance came back so i ordered more and my skin cleared quickly again. So basically now im adding it to all my cycles.

Get an exfoliating shower washcloth so that you can reach your back. Put a salicylic acid cleanser on the washcloth and mix it in. Rub that shit all over your back/shoulders for a minute or so, but don't go so hard that your skin gets raw. Wash it off and let your back dry for a minute. You've now removed dead skin, opened up clogged pores, and disrupted barriers protecting acne/fungus.

Time to introduce shit that will kill the culprits. It may be Bacterial or it may be Fungal, or both, but often they are competing against each other. Benzoyl peroxide is tried and true for bacteria (2.5% is plenty), rub it all over and leave on for 2-3 minutes before washing off. Ketoconazole shampoo for fungal (1-2%), can add in Selsun Blue as well, leave on for 3-5 minutes. Hibiclens takes care of both but only use it a 2-3 times a week, 3 minutes on, also test a tiny amount at first on your hand just in case you're allergic. Start with one at first and see how it works, then rotate in other options to see if there's a difference.

Once its getting under better control you can be less aggressive with how often you use them, make sure not to over-do it which could cause unwanted irritation/inflammation.

Additional option would be to go to a dermatologist who offers compounding prescriptions for acne. Tretinoin + Clindamycin compounded cream will increase skin turnover and is a good topical antibiotic. It's not going to clear everything up overnight, but it makes your skin a very unappealing environment for acne while preventing more breakouts. It may actually even look worse at first while it brings all the deep cysts up to the surface, but that's to be expected.

Hope that helps, all advice that worked for me from personal experience.

Hey man i had this same thing too on everything even trt I tried everything vlbut accutane also. The one thing I did thst made my acne basically disappear was dhb. It dried my back out its like night and day.

Honestly it's a curse, I've been trying to get rid of mine. Basically my back gets the huge knot like pimples and basically small ones on my shoulders and some on upper chest. But nowhere else. I started at 20mg of Accutane for 30 days and have been running 10mg since. My shoulders are basically clear, but I still get a random few on back. I scrub daily with antibacterial soap on a back brush and then I use Nizoral on the back brush. The only sides from Accutane for me have been dry lips so far after 3 months of use. I don't plan on using it forever, but hopefully the glands close up or shrink, like I've heard they can do and eventually this won't be a problem.

As a side note, I messed up and let my Estrogen get out of hand. Developed a small lump under both nipples which I'm addressing with letrozole currently. So my hormones were all screwed up too.

Gear for 2 years. On and off for how long ? Most people I see with acne like this they. They just blast. 24-7 and only say they take breaks(not saying that's you) Just keep it safe regardless, and agreed that is a lot of arimidex ran at that dose. Get blood checked. Maybe look into aro, you might be a non responder to arimidex and or not as good as it's supposed to be, but bloods are key,
And. 500 mg is base,, sometimes less is more. We all react differently, to hormones but. Obviously this is an extreme case.
I would get bloods before adding more stuff and if you pick acutane, get some chapstick
Prayers bro

You could look at antibiotics, doxycycline would be a good starting point as it will help if it’s acne and folliculitis. Another medication though……

Thats a lot of arimidex for a small dose of testosterone. Have you ran blood test to see if it is real arimidex? Do you break out this bad every time?