Can chest acne be permanently fixed, and what are recommended treatments?

Chest acne is treated in a similar manner as facial acne and the treatment options have be quite comprehensively discussed elsewhere in this forum which you can refer to. They include topicals, oral antibiotics and oral isotretinoin.

The main difference is that chest acne tends to respond more slowly than facial acne and may be more prone to cause thickened scar (acne keloids).

Also acne mimics such as Malassezia folliculitis need to be excluded.

Do consult your doctor for a clinical assessment and discussion on which medication is best suited for you based on the severity of your chest acne and previous response or non-response to medications given.

Chest acne which is a form of truncal acne (including the chest and back) usually does not respond well to topical acne preparations in my experience. This could be due to non-compliance with the treatment as it is usually more inconvenient to apply something on the chest or due to the slower response rate.

In my clinic, I would normally recommend a course of oral antibiotics with or without
Roaccutane depending on the severity of the condition. Unfortunately, the results, although good, cannot be considered as a permanent cure as acne tends to be a chronic recurrent condition.
Hope this helps.