My brother had it so bad, especially around his neck, when he was a teenager he went to the doctor. Doc prescribed him a course of antibiotics and it worked a treat. However, we have always been a family that had very little exposure to antibiotics growing up. We didn't rush off and get prescribed antibiotics with every little sniffle and cough we came down with (which most of the time is useless because the cause of the sniffle or cough is usually a virus).
I know something of pharmacology, microbiology and bacterial resistance to antibiotics. And I tell you now, the more exposure you've had to antibiotics the more your own personal micro flora is likely to not respond to antibiotics. And the bugs in acne aren't some exogenous infection, their your own little friends turning on you. So if you "grew up" on antibiotics then treating your acne with antibiotics may not be terribly effective unless you use some of the top shelf stuff reserved only for special occasions (I'm a bit out of touch but back in the day the top shelf stuff was Vancomycin, and Methicillin).
Really nasty acne is not normal and can't be dealt with using the amateur "tried and true" stuff. You've actually got to treat it with more than the general advice of healthy eating, regular bathing, exercise and keeping your stress levels down (though all those things are helpful).
Whether you're a conventional medicine person or into the alternative therapies, if your acne is significantly worse than everyone else you know, then you have a problem that's not just normal teenage crap and you should seek professional help to get it sorted.
Personally I had a bit of an acne problem, but never bad enough to warrant specific treatment. I always found that a particular anti-acne product would work for a bit, then the little bastards would come back. Even though I'm well out of my teens (I'm probably old enough to be your dad, but only if I was a naughty teenager) I still get zitty from time to time, mostly when I'm under stress. I've always had a sleeping problem, so I can't tell you whether lack of sleep is a problem or not because my acne status has waxed and waned while my sleep patterns have remained constant (constantly bad).
“The fundamental cause of the trouble is that in the modern world the stupid are cocksure while the intelligent are full of doubt.” - Bertrand Russell
"When the power of love overcomes the love of power, the world will know peace."