For 20 years I have been prone to occasional breakouts and quite painful deep spots.
For a long time I though it was to do with hormones, worse premenstrually and that is certainly true to a point but really it gets so much worse when I "take care" of my skin.
For long periods of my life I've been so miserable with it that I did very little to my skin. Rinsed it with warm water under the shower and used a light (cheap) moisturiser when it felt tight but honestly, that is when my skin is at it's best. When I look after myself and have a proper cleansing routine the spots always get worse. I've tried loads of different cleansers over the years. ATM it's Liz Earle cleanse and polish which I did think made my skin better for the first few days but now it's worse than it's been in months.
I'm going back to plain water, even if my skin's still not perfect, at least it doesn't hurt! I know it can't remove all make-up properly but I haven't found anything that does without messing up my skin.