Hi everyone, I am making this post to ask for some advice or opinions. I am a 20 year old male who has really persistent cystic acne that has been annoying me for the last 3 years, and it never goes away no matter what I do. I exclusively get cysts on my cheeks only and I have tried literally everything, gone to dermatologists, tried azelaic acid, tretinoin, benzoyl peroxide, niacinamide, antibiotics (doxycycline and tetracycline), with the exception being that I have never tried Isotretinoin because my profession unfortunately does not allow me to use it (aviation).

I am 90% sure its hormonal acne and dermatologists have also agreed, mostly because my mother had really bad hormonal acne in the past so I suspect I got it genetically from her. And I get my acne exclusively on my cheek which further supports the hormonal claim.

This, combined with me trying countless of dietary and different treatment changes which have not worked, is leading me to think that increased DHT levels are most likely the culprit of my acne, something that none of the aforementioned treatments have actually targeted.

(Regarding potential DHT levels; I have a lot of body hair, not much facial hair and have no hair loss or thinning as of writing this.)

So I am curious what options there are for me at this point. Most hormonal acne treatments which are successful are for women and consist of spironolactone which males cant take because of feminisation and similar side effects. I have seen a product called Winlevi but I am in europe and I dont think its sold here. Could any hair loss medications maybe be useful? Just thinking out loud at this point

Curious to hear your opinions and advice.