Hi everyone,

I'm a 27F and I've been dealing with acne since my teenage years. I'm honestly exhausted trying to figure out what's causing it.

I've tried multiple dermatologists, consistent skincare, quitting sugar, working out regularly, avoiding oily food, and even used tretinoin for about 3 months in 2024. My skin became almost clear for around 6 months, but then the acne slowly came back and now I'm back to square one.

The biggest issue is that every new breakout leaves behind pitted scars and pigmentation. I've already had 4–5 micro needling sessions and 2 subcision sessions, which helped, but as long as I keep getting new acne, I keep getting new scars. I'm planning to restart scar treatments in a couple of months, but I really want to stop the acne first.

I've seen people mention in this sub that they were prescribed birth control pills and noticed a significant improvement in their acne. How safe and reliable is that option in the long run? Since I'm unmarried and have never explored that route, I'm wondering if that's something I should consider.

If you were in my situation:

* Should I see a gynecologist?
* Which blood tests or hormone tests would you recommend to look for the root cause?
* Has anyone here finally figured out the reason behind their persistent acne after struggling for years?

I'd really appreciate any advice. I feel like I'm treating the scars over and over, but unless I stop getting new acne, it never ends. It's really affecting my confidence and self-esteem.

I've attached photos of my current skin. Thank you so much.

Acne for 13+ years and nothing seems to work. What am I missing? (27F)