Hello, i am new and need some advice/guidance. I am currently 23 female with cystic acne. I have had acne since I was 10-11 started puberty at 9. It wasn't too bad looking back on it it was normal zits that went away. 2 years around I started getting hard lumps on my face that would come to a head. I think I was over drying my skin with over the counter products when I already have dry skin to begin with. Now I am stuck.. I have tried so many options from over the counter to holistic and fitness. I really don't want to do accutane but I can't seem to find anything that helps. I eat a very clean diet (paleo) and exercise about 30+ minutes 3+ times a week. I don't drink very much water (which might also be a reason?) And I have always had weird periods. The older I get the heavier they are and only last about 2-3 days. I get intense cramps to where I'm about to faint and find myself laying on the floor in pain.

My current routine is lemon/tea tree/olive oil sugar scrub in the morning followed with ceraVE (no makeup anymore) then when I go to bed I steam my face for 10 minutes and follow up with a 59/50 acv/water mixture.

Also, I work in a backroom so I'm touching boxes all the time which 2 years ago (working freight/stocking) made my arms break out badly. Now my arms are used to it but my face breaks out badly. I started working in the backroom and my face broke out badly.

I'm not sure if its hormonal or from my job, dealing with the powder/dirt on the boxes.

Any feedback would be appreciated. I'm open to holistic answers as well~