Hi everyone,

I'm a 29 year old male who's struggled with acne for over half my life. Over the last decade I've used the following: a slew of oral antibiotics, topical treatments (Tretinoin, topical antibiotics, Duac, Ziana, etc.), 3 rounds of Accutane, and other herbal treatments like Acnease and Clearetto. My acne isn't severe anymore, but I consistently get breakouts in the *same exact area*: the area below the corners of the mouth (picture attached for reference). This seems like a case of hormonal acne, and I was wondering if someone in a similar situation has tried anything that's worked well. Browsing through the forums, I've seen various treatments including:

• DIM
• A combination of: Saw palmetto, Stinging nettle, Pygeum, Pumpkin seed oil, Beta sitosterol
• Topical spironolactone
• Propecia

I'm very desperate at this point and it's frustrating that I keep breaking out in the same exact areas (and they're often cysts that last for a good couple of days). Accutane has been the only thing that has kept these breakouts controlled but I don't think it's worth the side effects given my acne is not severe overall. I'm not sure where to start with the list above so any advice would be appreciated.

Thanks so much for your help!