Having large, pus-filled acne for many years can be very frustrating, especially when multiple treatments have not worked. From your description, it sounds like you may have severe inflammatory acne, which often needs long-term and properly supervised treatment. Oily skin can increase the blockage of pores and make acne worse. It is important not to squeeze or pick the pimples, because this can increase infection, scarring, and dark marks. Wash your face gently twice daily with a mild face wash made for oily or acne-prone skin, and avoid harsh scrubbing or using too many products at the same time. Also, avoid heavy creams, oily cosmetics, and excessive junk or high-sugar foods if they seem to trigger breakouts. Since your acne is severe and persistent, you may need prescription treatments such as medicated creams, antibiotics, hormonal treatment in some cases, or medicines like isotretinoin, which are often used for severe acne that does not improve with routine treatment. However, these medicines should only be taken under the guidance of a dermatologist because they may need regular monitoring and can have side effects. Treatments for acne scars and marks, such as chemical peels, laser treatment, or scar procedures, can also be considered after the active acne is controlled. Stress, poor sleep, hormonal imbalance, and conditions like PCOS can sometimes make acne worse, so these may also need evaluation. Consulting a dermatologist is the best step to identify the exact cause and start a treatment plan that suits your skin type and severity.