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Please keep up the fight! I can really relate to that lack of confidence in public.
I'm on anti-depressant/ocd meds, really!
I'm 36 and have been dealing with this technically for 16 years, although I can remember slathering clearasil on my face at 14 or 15, hoping it would ward it off. The decision to keep going in life has been a huge milestone for me. For many years, I really hoped I wouldn't live to see 36! That's the age my mother's sister took her own life, and being her only daughter, realized I just couldn't do that to my mom.
I am married and have a beautiful 14 month old daughter, what an accomplishment! It is a miracle for me a sign of God's mercy and grace. I need to trust him to the end, otherwise I will miss some awesome things.

Also, am a 3 time user of accutane. the side effects were killer, including such pain and stiffness in my joints that my doc made me stop, just about 4 weeks short of the complete program. The acne always came back, although to a lesser degree, and now in the form of congested skin , bh's and milia. The emotional and psychological ramifications are disappointing to say the least. Regarding topicals: retin a wrecks my skin, breaks down the integrity so you are more prone to irritation and infection, plus you still have the plugged pores that now if you try to do an extraction causes a major disaster. Anyway, try not to put so much pressure on yourself, people love you and need you and you are worth so much more than the condition of your skin.
Try living a balanced life, exercise, find relaxation, get enough sleep, eat right, maybe you are sensitive to certain foods?
Use dye and fragrance free detergents, no dryer sheets, make sure your shampoo and skin products are non comedogenic ( by individual ingredient, not by the statement on the label.) Try gentler, milder treatments, so as not to aggravate the skin.
Keep fighting, this too shall pass.

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