There have been at least two studies showing that eating a low glycemic, low carbohydrate diet can greatly diminish even the worst acne problems. But, that involves a diet that the vast majority of people aren't willing to follow, and involves replacing processed carbs with healthy alternatives. So yeah, the evidence shows it works. But no one is willing to do it.

I used to take doxycycline 200mg per day (even 300 a couple times) during breakouts for up to 12 days or so. I always drank kefir or probiotic yogurt at a different time of day when taking it to prevent any possible gastrointestinal imbalance. It's one of the safest and most effective broad spectrum antibiotics for short term use, as long as it hasn't passed its expiration date, because it starts to break down after siting on the shelf too long. That's something you could ask a dermatologist about.

Doctors often prescribe 50mg doxycyline for "long-term", but that dosage doesn't do anything for a lot of people. I found it more effective to take a higher dosage over short term period when it got bad. In fact I saw very bad acne disappear in less than a week on 200mg.

Something else that can help according to studies is blue light, which involves sitting in front of such a light while you read or something in the morning for 20 minutes or so. (No, a blue incandescent won't work.) You can google this. Most places really rip people off with these lights, though. Probably the best one to buy is actually designed for people with seasonal affective disorder (sad). In other words, it's a light meant to help wake someone up in the morning and reset circadian rhythm. If you google the following string: golite sad light

That would help you find one. Sometimes ebay has them for cheaper.

You brought up the issue of nutritional supplements. Personally, I think the recent studies with green tea extract show it would likely be more beneficial than saw palmetto. And its health benefits are touted all the time in studies for reducing oxidative stress, etc. It moderates and balances male hormones to some extent, and it also reduces inflammation. Wal-Mart probably sells the extract the cheapest. There are other supplements that are potent anti-inflammatories. For example, ashwagandha.

And before I close, I'd like to mention face creams (yeah, I know it's not a guy thing). But there's a face cream called Rejuvenex that has twenty-some antioxidants that over a three week period could help to greatly reduce skin inflammation and acne. What would probably happen is that the first week or so the acne would actually get worse because more moisture would be added on top of oily skin. But then what can happen is the skin cream would signal the skin to down regulate production of oil, and around the same time the anti-inflammatory ingredients would start to kick in. If you were to try this, you'd have to discontinue any medicated soaps or treatments and just use a gentle, non-medicated face soap and wash cloth before drying and applying it on your face.