Less than two months out from my wedding, and my skin is worse than ever.

Sorry in advance for the long post. I’m at my wits end with my skin and looking for any help I can get.

My wedding is in September and my skin looks terrible. About a year ago I started seriously working towards clearing my longtime hormonal acne, and since then I have spent thousands of dollars on skin treatments, facials, products, supplements, doctor and naturopath visits, and prescriptions.

I’ve always had really bad skin, and last year I decided to try going off birth control and try to control my hormones naturally. I got to a point where I seemed to be seeing progress after getting off birth control and starting taking DIM supplements, but it came with severe side effects. My periods since going off birth control have been extremely heavy and painful to the point of being nearly bedbound for a couple days each month and typically have severe fatigue for over a week. The DIM supplements caused abdominal cramping and bloating. As you might expect this has made my quality of life very poor as I can’t do things I enjoy or focus on work. I honestly barely left the house for a couple months because of how much pain I was in.

About two weeks ago, after a particularly bad period, I hesitantly decided to go back on birth control, which I didn’t want to do because I am planning on on trying to conceive in the next year or so. Since then my skin has gone completely off the deep end and I’m kicking myself for doing this. I’m not only dealing with breakouts in the usual spots, but all over my face and also poor texture, clogged pores, blackheads, even my pores look bigger. I have bumpy skin all along my jaw and my skin just feels irritated even though I’ve been using a very minimalist, gentle routine.

I know there’s no way I’ll be able to clear up the scarring by my wedding even if I manage to get rid of the acne and texture I have no. As my skin has been my lifelong biggest insecurity, all I wanted was to have one day of clear skin for my wedding. Especially being 32 and suffering from acne for over 20 years, I really want to someday feel confident in my skin and not have to think about it 24/7.

Does anyone have recommendations to help? Should I try going off birth control again? Or should I stop the DIM supplements and just keep taking the birth control and see if it passes on its own? Is it my routine that’s the issue?

My current routine is:
AM: Acwell pH balancing toner, skin 1004 Centella ampoule, skin 1004 sunscreen
PM: Garnier micellar water, Naturium gelee cleanser (or be plain mung bean cleanser), skin 1004 Centella ampoule, cosrx oil free ultra moisturizing lotion.

Also to note: Tretinoin gives me dermatitis in any formulation or concentration so I cannot use that. AHAs also cause breakouts. I use a BHA 2% toner from Naturium a couple times a week but any more than that causes severe irritation. Azelaic acid also causes irritation. I took accutane about 10 years ago and it helped but obviously didn’t cure the underlying issue which I believe to be hormonal.