Over time, my body has gotten used to using gear and acne hasn't been bad. But I did get bad acne when I first started. I used accutane and it made a world of difference. For someone that gets bad cystic acne, it might be the only option. This acne is being produced deeper in the body. It often has less to do with your skin being clean. Still clean skin will help. Try some Dial anti bactera bar soap. The yellow/orange bar.
Also, I've found that the more I split my shots up through the wk, the less acne I would get. Doing EOD shots with long esters has helped me. With short esters, ED shots. Stable hormones help. If you need to, go back on accutane for another course, through your Dr, and it may keep you from breaking out on fugure cycles. If you are running gear while using it, be sure to avoid using orals