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Week 8 problems... and PCOS question

I’m just finishing week 8 on the regimen and prior to this week I was finally getting clear! However, I added in the AHA about a week ago and my face broke out a day or two later in painful, deep spots under my jaw and around my lips. I also had a stressful event happen so that could also have contributed. Is it common to still have breakouts at this point in the regimen?

My acne has been moderate but persistent and I’ve always been afraid that if I don’t take measures against it that it would explode into severe cystic acne. Over the years I’ve been on oral contraceptives consistently until eight months ago. I was completely clear when I quit the pill, but the acne came back around the 3rd and 4th month. By month seven off the pill and the acne seemingly getting worse, I decided to start the acne.org regimen. I’ve seen improvements no doubt, but the persistent hormonal acne keeps coming back. I’m curious if the regimen is still effective if the underlaying cause of acne is PCOS or some other hormonal imbalance? I’m currently undergoing lots of blood work to determine if lean PCOS is at work, but results have been inconclusive.

Current picture of the breakouts around the mouth. They are kind of white due to spot treatment of BP. You can also see some of the scarring around the mouth from past breakouts there.Not visible are the painful active nodules along my jaw. There are three currently.

3C8CC3DF-DABD-414F-83B8-7C59FA6EB348.jpeg.76f3d8c522cfc0aa8151b5f746efdefb.jpeg

Below are my week 7 results prior to my current breakout.Pretty clear! I never get spots on my cheeks or forehead, unless I wear a hat and get really sweaty and dirty, in which case a hairline pimple will occur. 

68EFE294-7CCC-41F6-9C09-854E78933AC9.jpeg.24050056c4d94b1d8d5de7755bbd3c46.jpeg

 

 

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I have lean pcos but didn’t get diagnosed until they did an ultrasound and saw my ovarian cysts. I got a bad breakout going back on birth control at first but 100mg spironolactone helped immensely. Spot treating with dapsone 5% has been the only topical that helps my acne. 

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