Anonymous bemoans his/her persistent acne and combo-oily skin for over two years, and was wondering what I recommend to help the problem.
Persistent acne (especially for such a long period of time) usually indicates that this is not hormonal, nor environmental. The probable causes of this type of acne are genetics or something else that you have less “direct” control over and is a constant aggressor in your body.
Unfortunately, acne such as this (like the type I have) should really be treated with prescription-strength medications. There are a variety that your dermatologist may prescribe, including benzoyl peroxide (such as Duac gel/cream), adapalene (Differin), the two mixed together (EpiDuo), a topical retinoid (Retin-A or Retin-A Micro), a tetracycline antibiotic (minocycline, doxycycline, tetracycline, oxytetracycline, or Soladyn) or an isotretinoin (Accutane). Often, an oral antibiotic is prescribed in conjunction with a topical (many of which the bacteria that causes acne cannot build up a resistance to).
So, the first step is finding yourself a good dermatologist. Next is fighting it on your own. What you do from here depends on your skin type. For combination skin, I’d recommend washing your face no more than twice a day with a mild cleanser (all types of skin LOVE oil cleansers, which help balance both dry and oily skin. For a cheap alternative to the more expensive ones from Shu Uemura, try the Kose Softymo Deep Cleansing Oil). Moisturise with a light lotion, like Velva Moisture Film by Elizabeth Arden, and make sure to wear sunscreen every day (I love Sheer Touch by Neutrogena).
The final thing you can try, though it has no guarantee to work, is modifying your living habits. Smoking is known to exacerbate acne, so cutting that out will undoubtedly help. But the biggest changes you can make would be with your diet. Many people (including myself) find that cutting out dairy can do wonders. For a year, I switched over to completely soy- and almond-based “dairy” products, and saw a tremendous change in my skin. Now I limit the amount of dairy I consume and continue to see results. However, these modifications have to done to the fullest. For the first course of “change” you have to completely cut whatever it is out, and then slowly fade it back into your diet. No cheating! Other things to consider cutting are processed sugars (also did this one with great results), processed wheats (tried this, but saw no difference), and red meat (I don’t generally eat it anyway, so I’m not sure if that has had an effect or not.)
Try these things, get to a dermatologist quick, and let me know what happens!