Hi! I am so sorry about your dog  my first guess because of a heavy dose of stress. Stress can cause a lot of things in your body to go into panic. Anything from your immune system to your ph balance. (Stress can create a more acidic ph balance which can lead to acne in some) Quick question. How do you know it's hormonal or do you just assume? I haven't tried that specific treatment but here are some things I would recommend. Start using dilluted Apple cider vinegar as a toner after you wash your face. It balances out your skin's ph (which should be around 5.5). Try a good brand of essential oils. Tea tree and clove oil have been working wonders for me personally. Make sure to moisturize. I recommend pure raw shea butter since it doesn't clog pores and is good for your skin. Start drinking a lot of fresh squeezed lemon with your water. This helps alkanize your body's ph, gives you energy, great for mood enhacement, and is a great help to your liver. Try to be positive and believe that it's all going to go away. I know this might sound a little silly but seriously. Your brain technically controls your whole body so if you believe in something hard enough for  a long time it will eventually happen. I know how you are feeling though. I've always had acne but very mild. One day, I just started getting so many pimples. In a matter of  week my face was covered in spots that would not go away and only get worse with any treatment. I got so depressed and basically quit my social life. Only now, a year later, am I starting to enjoy life again. Just don't give up. I hopes the things I mentioned could help but if they don't, don't lose hope. We all have such unique genetics and dna that it's hard to find a universal cure. Another thing I would recommend is trying to eat more of a raw vegan diet. Try to include fresh veggies and fruits with every meal. i am also vegan and i recently started doing that and  am seeing  a huge difference. And don't pick. I know it's tempting but sometimes that can push the puss deeper and then that pimple will stay longer.

Thank you so much for replying it means a lot. First i feel you and im sorry you have to go through any of this. No one should ever have to feel this way. I know it's hormonal acne because my dermatologist told me that's what was going on. And surprisingly even being vegan i don't include fresh veggies and fruits...I'm definitely gonna start. I will look into essential oils as well, I've already tried apple cidder vinegar. And that lemon water advice i will definitely try! I would love to hear anything more you have to say, again thank you so much.

And if you don't mind me asking, have you experienced PIE? If so, did you get rid of them and how so? And have you tried the acne.org treatment kit?

I have to respond because your story sounds so similar to mine. I am 24 years old as well and I eat mostly vegan (with the occasional fish) and I've dealt with random skin issues in the past year. I'm about to graduate from esthetics (skin care) school as well so maybe I can help you out. You're doing everything right, and you're treating your body the way you should, but mentality is key. My acne flared up TERRIBLY due to chronic stress from so many things that happened and I started breaking out like crazy which put me in this vicious cycle. I went from barely washing my face and never getting acne to all of the sudden being covered from the chin up. It took such a toll on me and I wish someone had told me my stress had taken ahold of me because it took me awhile to figure it out. I have cleared my acne, but I'm left with PIE marks as well. Just remember nobody is perfect and everyone has imperfections. PIE marks can take anywhere from 3 months to a year to fade completely. If you want faster recovery IPL laser sessions will heal them faster (3-6 sessions). The sun can also darken them, so make sure you're wearing a quality SPF. Also do your very best to break the habit of picking your skin. Write positive notes on your mirror or do whatever it takes to avoid it because that will only cause long term damage. Lastly, I say listen to your dermatologist and give the regimen a shot. Everything works differently for everyone. I spent so much time getting opinions and trying to figure out what works for everyone else, but we are all different and it takes trial and error to know what works best for US. Remember to give his regimen at least four weeks of 100% consistency or you'll be right back at square one. I'm so sorry to hear about your dog, I know how hard that is, but things will get better!

One more thing, look into L-theanine for anxiety. It's 100% natural and helps enhance your mood. It's a great supplement as long as you're not on any anxiety/depression medication already.

Honestly I have to say I teared up a bit like a weirdo because your words were so kind and sincere and just all around gave me hope. And I'm gonna look into those supplements right after I'm done typing this actually. and I have been diagnosed in the past for anxiety and minor bi-polar I just never went and had it treated. If you don't mind me asking how did you manage your stress? because I feel like I'm caught in a loop; I stressed which led to acne, and then I stressed about the acne, which just leads to more acne. And I don't have the funds for the surgery for my PIE....is there anything in particular you did to help speed up the process of healing those marks? Thank you for your help and for replying. 

You'll get through this I promise And yes I have a bunch of that. What's helping me is the Apple cider vinegar and aloe Vera that I am using. But they can take time to fade unfortunately. For hormonal balance I would recommend: maca root and ashwaganda. They are both natural herbs that help balance your hormonal system. It can be hard to achieve hormonal balance especially if you have PCOS (which is what I have) but sometimes it's very easy. Main principles is to exercise weekly, eat a clean diet, and lose weight if you are overweight. What truly is helping me is my diet and stress reduction. Also avoiding inflammatory foods and activities such as smoking. Also make sure you are getting all your essential amino acids including lysine. I've been doing constant daily obsessive research over this problem for a year so I have so many different tips that I've read from people and scientific/medical studies. I hope I am not overwhelming you with all of this. A good beginning step is to eat more greens and drink lemon water as well as manage stress levels for sure though. I would try to steer clear as much as possible from antibiotics.

That's not weird at all, I'm so glad I could give you hope in a moment of sadness. Trust me when I say things WILL get better. You WILL get your skin back, and you'll have a whole new level of empathy for other people dealing with emotional conflict, skin issues included. Anxiety plays such a large role in our skins health. There's many things I do to manage my stress. I have a journal called "My book of positives" and everyday I write down three things I'm thankful for (it can be anything like things we neglect- food on our plate). I also downloaded an app called Insight Timer and I try to meditate every day, even if it's only for one minute. I write positive notes and put them on my mirror to remind myself that I'm enough and I am lucky to live this life. I try to sit outside and enjoy nature more often. There's so many things you can do to keep yourself in a positive mindset but the most important thing is consistency. Don't fall prey to those negative thoughts, or the feelings where you compare yourself to others. You are unique and you will be a stronger person through the face of adversity. Only you can change your mindset, and sometimes you have to fake it until you believe the new positivity you strive to achieve. Definetly look into L-theanine and also look into GABA (gamma-aminobutyric acid). They work great together or individually to help enhance your mood naturally. In regards to the PIE marks, it will take some time even though I know you hate that answer. The good thing is they heal much faster than hyperpigmentation. Some people find it useful to apply vaseline to the areas at night to help lock in moisture and maintain a healthy barrier. I'm a fan of what the user above said, apple cider vinegar can be very helpful to treat active acne and post acne marks. Make sure you dilute it 50:50 with water. Lastly, a hydrating moisturizer is key to healthy skin so don't neglect this step. It will help heal your skin faster. Remember, less is more, especially less stress. All the products in the world won't cure stress breakouts. Stop the cycle, you're the only one that can. Best of luck!!

Thank you both for all the advice, I feel better and much more positive about this situation. I am definitely gonna look into everything both of you said and so on. I appreciate all the support and love!