I've had hormonal cystic acne for 15 yrs;I'm 26 now.The cysts always come back in the same locations, esp. during my period. Been on Monodox for 3 or 4 months & it's stopped working.The acne/hyperpigmentation outlasted/were exacerbated by laser hair removal, aldactone, Retin-A, Dianette-everything but Accutane (& even then, I'd break out a little during menstruation). I want a revision rhinoin 6 months but have such thick skin I'm tempted to go back on Accutane. Is surgery the only alternative?