Here is my acne journey thus far...

I began to get pimples in 4th grade and saw my first dermatologist at that time. I was prescribed topicals and continued on these until 8th grade when I began the antibiotics: tetracyclines, doxycycline, amoxicillin, you name it.
Some of them worked to clear my acne, some didn't. I also took Retin-A.
I had combination skin and my forehead was the area most covered in zits.
By sophomore year of high-school, I began to get large cysts on my forehead and pimples around my mouth and my cheeks. So, I went on Accutane for 9 months (although I only took it for four because of the dry skin and my skin had been cleared)
No extreme side effects, and my skin remained clear for a year. What a glorious year.
I also decided to become vegan.
Unfortunately it came back with forehead cysts and the like and I took azithromycin to fend it off.
(This is when I realized that I got my acne every fall, and was clear during the spring and summer...)
The fall/winter after I graduated, it hit me like never before.

Cysts, pustules, papules, covering my cheeks, jawline, and mouth. (none on my forehead)
I was working at a ski resort and broke veganism. I wasn't eating a very healthy diet either.
I had gotten an paragard IUD inserted earlier that summer.
I was put on azithromycin again, it didn't do shit.
So, I went on spironolactone.
After 3 1/2 months on it, during which I experienced migraines, I decided enough was enough.
That spring, I got my IUD removed and stopped taking spiro.
My skin instantly cleared for the spring and summer.

Cue to this fall: the acne attack is back
Just as inflamed, and cystic as ever.

I started Yaz almost 2 months ago and am on my first month of my second course of Accutane.
I am vegan again.
I'm trying an elimination diet. I am currently not eating diary, meat, wheat, added sugar, peanut butter, grains, potatoes, and corn.

I'm sick of the physical and emotional pain that comes from cystic acne. I'm tired of the self-isolation and depression I experience every fall and winter. The social anxiety and hyperconsciousness about the appearance of my face and how people will react is draining. It's hard to find strength when you feel disgusting. It's hard to live life without obsessing over every bump.

I just started college. It's hard to focus on studying when all I can think about are FOD-map diets, how do I heal my gut, do I have a candida overgrowth, do I have a food sensitivity. I can't even begin to imagine the amount of hours I have poured over acne information in forums, youtube, or other platforms online.

I wish acne would simply go away.

These photos are from this fall and were taken when my acne was far from it's best, but not at it's worst, enjoy.

My questions for the acne community are as follows:

What does acne primarily on the cheeks mean? (if anything)

What are causes of seasonal acne?
-if you have experience with this, is it just the sun that halts your acne?

Do you have similar experiences?

Please share!