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In my early teens I hardly ever got acne. The worst I got was blackheads and maybe a tiny spot once a month. Half a year after I turned 18, I started getting hard, painful bumps on my cheeks. Several at a time. They take ages to go away. They aren't huge - they're probably around the size of the eraser on a pencil, maybe a little smaller - and I very much doubt they have anything in them (I've found this out the hard way by trying to pick at them in the past). I just have to wait until they slowly get smaller and then leave behind a red mark that lasts a long time and eventually fades.

I have two questions: what are these things I'm getting? I've looked at pictures of different types of acne but I'm still not entirely sure... what does it sound like to you?

Second - since I've only started getting them now, at 19, what might be causing them? Is it a hormonal imbalance? Would birth control help if it was?

I should mention that I've asked my doctor about all of this on several occasions. She's prescribed Clindoxyl and Benzamycin for me in the past, both of which have only made my skin worse. I asked about being referred to a dermatologist (I'm not sure how it works in the US, but in Canada - at least the part of it where I live - you have to be referred to see a dermatologist, and after you're referred it often takes quite a while before you get an appointment, sometimes months) and she doesn't seem to think my skin problems are serious enough to go to a dermatologist with. To me they are serious because it has been my main concern for the past year of my life and essentially ruined my first year of university. So any opinions as to what this is or what I can tell my doctor to convince her that I need more help than I'm getting would be appreciated. (My doctor has been absolutely amazing with everything except for this particular issue so I'm not considering switching doctors. I just feel like I need to make her understand how serious this is for me, and that topical treatments are not enough at all.)

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They sound like cystic pimples. I get them. And nobody is completely sure what causes these. It could be a hormonal imbalance but its probably a variety of little problems that create these things which turn into big problems. I'm a guy so idk much about the pill. In the U.S. you can go see a dermatologist if you want. No recommendations or anything. Sorry you don't have that freedom but did you talk to your doctor and tell her how bad acne is taking a toll on your life? That should work but if you did that then dang... idk. But i hope i was of some help.

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