Cystic acne help

Ive struggled with cystic acne ever since my teens years and Im now in my 40s. My skin is otherwise clear eg no small pimples so it's not a poor skincare issue I dont think. I get them sometimes on my face but also odd places like lower back, ear etc. My hygeine is good. Years of dermatologists and various creams and antibiotics, nothing has worked. Has anyone succssfully cured it? If so, how?