What can I do if Obagi Nu-Derm isn't working? (photo)

The first thing you should do is stop wasting precious time and money experimenting with this or that product line and get yourself asap to a board certified dermatologist who can prescribe an appropriate regimen to treat your existing cystic acne before it leaves permanent scars and to reduce or prevent future outbreaks. It is important to note that the more intense and persistent the acne inflammation, which is typically the case with cystic acne lesions, the more likely it will be to leave permanent scars, particularly if the cysts persist for more than 21 days. It is for this reason that it would be advisable to seek consultation and treatment asap. In-office, the dermatologist can open up and evacuate closed comedones (whiteheads) before they erupt into full blown acne and inject cysts before they cause so much damage to collagen and elastic fibers that the affected areas heal with permanent scars (e.g. boxcar, rolling scars, ice pick scars, hypertrophic scars, and keloids).  The dermatologist can then prescribe real and appropriate at-home-use topical (and occasionally oral) medications to help prevent new acne formation. I hope this helps. Best of luck.

If your acne is resistant to the Obagi Nuderm system you more than likely have a form of cystic acne which will require multimodal therapy.  Seek the advice of a board certified dermatologist who has treated many acne patients.
I hope this was helpful.
Dr. B