This review article — comparing several commonly-prescribed treatments for acne — ends up close to what I figured out as a graduate student via self-experimentation: that benzoyl peroxide works much better than antibiotics.
I like to think that in 100 years people will look back on current treatments for acne (and a hundred other things) as medieval, like leeches. If Weston Price had been a dermatologist, we would now have evidence, I’m sure, that certain traditional lifestyles produce very low rates of acne. Examination of those lifestyles would provide good clues about what aspects of our way of life cause acne. That would be a good starting point for experiments to zero in on what matters. Once we knew the environmental causes of acne, such as caffeine or soap, they could simply be avoided; no need for powerful dangerous expensive medicines. At the moment, however, determination of what aspects of modern life cause acne isn’t even close to being studied. You might think it is better to study safe cheap cures than dangerous expensive ones but you’d be wrong. At least now.
