Happily, these days treating acne is not a case of "All we have is a hammer, so everything must be a nail." Owing to the great number and variety of agents currently approved for treating acne vulgaris (common acne that once called "teenage" acne), we can now individualize the at-home and in-office treatments of this problem to the specifics of the patient.
If indeed, the problem is one truly cystic acne, this generally requires more aggressive treatments--often a combination of in-office anti-inflammatory injections, acne cleaning, and the application of specific peeling agents--in conjunction with at home use of topical retinoids, such as tretinoin, adapalene or tazaratene; benzoyl peroxides--either alone or coupled with a topical antibiotic and perhaps even a short course of an oral antibiotic (although I seldom find this necessary) and/or antiinflammatory oral nutritional supplements. Other topical agents may also be needed. To determine what is best for you, consultation with a board certified dermatologist with extensive experience in treating cystic acne is strongly advised.