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I've had acne since I was about 12 years old. In the first five years of having acne it was pretty minimal. It was still 'ugly' but it attacked mostly my forehead with many small blocked pores. It wasn't until I was about 17 that I had my first cystic pimple or nodule. It was filled with blood, about an inch long, and bled for ten minutes when I finally jabbed it open. I went to a derm and got prescribed Accutane right away by her, accepting it without enough background knowledge on the drug. The Accutane made me even more severe and left me with many scars and side-effects. It worked for about 6 months but slowly the acne came back and completely worse than before! I'm now nearly 20 and I'm suffering with a new cyst or nodule every week. 

My question is: can my acne still be hormonal if it doesn't really alter that much throughout each month? I think it used to pop up exactly two weeks after I finished my period but ever since I moved to England it's been nearly every few days that I get a new cyst! I now also suffer period cramps which I never used to get so that's a bummer. I'm worried that I'll go on a drug like Spironolactone and make my acne worse because it's not hormonal.

My acne is mainly cystic and on my cheeks. For the longest time it only affected my right cheek and after moving its now affecting my left as well. I'm extremely depressed and often hide indoors with the lights off. I've contemplated suicide weekly and all I want is some control in this situation. At least just knowing the cause. I can't see a derm or a doctor since I'm not a British citizen. Everything I do will be on my own. Please help me with what you think my acne is caused by!

P.S. I contrasted these photos and I'm wearing some gross Vaseline on my lips because of Accutane so I apologise. I've never shown anyone my acne before so no making fun of me :'(. You can see a few lines on my bottom cheeks which are Accutane scars. I don't have any large nodules or cysts right now but I have one starting and it hurts without touch!

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Hi! Sorry, you have to deal with this, acne sucks! Try not to feel too down about it, you are not alone. 

Your acne CAN be hormonal even if you don't notice it fluctuating with your monthly cycle. Actually, it was the same for me. My acne is hormonal, but it doesn't really fluctuate around that time of the month or anything like a lot of people experience. I know it's hormonal because I have been on birth control for almost 3 full months now and have seen a HUGE improvement. 

Usually when people with hormonal acne take accutane, it either doesn't work at all (as with your case) or it works, but the acne comes back at some point once you finish the meds. 

Since accutane did not work for you, it makes me doubt that the traditional topical and antibiotic routes will be a permanent solution for you. It makes me lean towards thinking it is an internal or hormonal issue, but I am certainly no doctor! It's tricky because you cannot get to a doc to get blood tests done or to talk to them about your experiences. Since that's the case, you are going to have to rely on your own research and experiment different treatments. 

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I agree its likely hormonal.looks a lot like mine which like kellbell, has improved a lot with birth control. Maybe you could go to a womens clinic or get a nurse practitioner? I mean if you got sick you'd have to see a doctor anyway...
Try spearmint tea and chelated zinc.

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