Hello all, So I'm doing a lot of things to control my horrible onset of cystic hormonal acne. I mistakenly went off of birth control after having been on it for 12 years and my skin went crazy. I'm almost at the end of my second pack and things finally seem to be under control. I now mostly have hyperpigmentation. Up until recently, my skin was awful and I'm pretty sure starting this birth control made things way worse. SO...In addition to birth control, this is what seems to have worked for me.