I've been doing a ton of research the past few days, including from my textbooks (I'm in medical school) and I think I've figured out my problem.
Last winter, I took Next Choice/Plan B pill (levonorgestrel mega-dose) two times. I was also briefly on Alesse a few months back (same thing in lower doses) and I also had to take an oral steroid for bad poison ivy. I was also under a LOT of stress and had some digestive problems during the same time. A mess, I know, you'd think a med student would know better! But I trusted my primary care Dr. too much and I don't think she knew what she was talking about, looking back.
My skin had always been perfectly clear and glowing, I would get compliments from strangers. In the winter it started to get kind of congested looking and by May I was having big painful cysts appearing around my mouth, jawline, and on the edge of my cheeks. At first I didn't worry about it, but it got worse during the summer, even appearing between my eyebrows and being extremely painful. It took me a while to connect the dots, but it's got to be the hormones I took last winter. At this point (8 months later!) it is better, but I still have 2-3 active pimples around my mouth and redness from not-quite-healed older ones. Another hormonal indication is that I have a single dark hair that grows on the edge of my left cheek, that didn't used to be there, and several on my lower chest.
My diet is mostly gluten free, completely dairy free (dairy causes inflammation immediately). I eat sprouted legumes and grains, mineral-rich bone broth, grass fed meat and eggs, locally grown vegetables, I drink Kombucha and make my own sauerkraut. I currently supplement with fermented cod liver oil, high vitamin butter oil, zinc gluconate, MSM, biotin, and niacin; I don't think diet is the problem. I tried DIM for 60 days without success.
My plan A is to address the apparent high androgenic activity with natural DHT inhibitors.I realize this is in a way just addressing a symptom and not the underlying hormonal problem, ie, why is the androgen/estrogen balance whacked to begin with. But I'm hoping this will clear my skin while my body has a chance to heal itself on its own time.
I will be taking a standardized saw palmetto extract, licorice and spearmint capsules or teas daily.
I will add to my supplement regime: chromium and a tsp of ground cinnamon (for possible insulin resistance caused by the pill), a b-complex in place of niacin and biotin (for more balance), DIM every other day to eliminate xenoestrogens, and apple cider vinegar taken in water daily.
Likely I'll try this for 30-60 days without changing it and observe carefully. I'll report here because a lot of people seem to have a similar problem.
Plan B will involve talking to a few doctors AND naturopaths about my other options. I'm thinking progesterone levels could have a role in the root cause of unbalanced hormones.