Hi. I recently got bw done to see if I had a hormonal imbalance mainly due to my acne/closed comedones that I have been dealing with (Ive also been dealing with anxiety, depression mood swings, low libido etc). But my hormones have come back normal. Nothing even a little bit high or a little bit low. The only things that were abnormal were that my vitamin D was a little low, my b12 was on the low end of normal, and my lymphocytes were a little high. I am just so confused about what could be causing my closed comedones because they became inflamed pimples only at the end of my luteal phase, so it feels like its hormone driven.

Sorry this will be long but I feel like its important to the story so I want to give a background of my acne history. I got my first really bad acne flare up at age 14 during mid fall. but it was mostly inflamed pustules instead of closed comedones. They checked my hormones and said they were off the charts and I have never been able to find what those hormones levels were (this was almost 12 years ago). They put me on birth control and by late spring almost all of my acne had cleared up and stayed clear for the summer. Then a few months later in the fall, my acne started flaring up again (still on birth control although at one point I did switch from tri previfem to tri sprintec but those are apparently

the same thing). Around January of that year I had to go on accutane. Once again it cleared up by the summer and from then on I would only get a few pimples here and there. I stayed on birth control until I was 24 (so I was on it for 10 years which I know now may not have been good). I stopped BC in July of 2023 and October 2023 I started getting closed comedones all over face. I then had to go on accutane and by the spring all my closed comedones were gone. Then flash forward to November 2025 my closed comedones are back. I know that was so long but I just dont know what to do. If my hormones are normal then why is this happening to me? Could it be gut related? Liver related? For those who read all that, thank you. I just feel like my doctors are not taking me seriously and I just want to fix this issue its really impacting my mental health and I dont even know what to do anymore.