Since your severe acne and dark spots haven?t responded to topicals like Nadoxin and Kozic cream, you likely require stronger, prescription-grade options. For severe acne, dermatologists often prescribe oral retinoids (like Isotretinoin) or oral antibiotics (like Doxycycline), paired with topical Benzoyl Peroxide or Adapalene gel. Once active acne is controlled, treatments like Azelaic acid, Vitamin C, or clinical chemical peels can effectively target the black spots. I highly recommend visiting a dermatologist for a physical evaluation. They can safely prescribe these stronger treatments and tailor a regimen specifically for your skin type. In the meantime, avoid popping pimples to prevent further scarring.