26F Worsening acne and facial hair - but not PCOS?

Hey y'all! 26F, 5'8",124lbs. Caucasian. Low alcohol intake, no other substances, routine exercise, healthy diet and I avoid dairy. Not on birth control b/c lesbian lyfe.

• Starting in ~2016 or so (when I was 22.5), my persistent acne began its multi-year saga. I was using benzoyl peroxide, then nothing for a while, then tazarotene .05% in early 2019, then bumped up to .1% several months ago. Not much change, regardless of medication.

• Since around ~2016, my acne has steadily gotten worse regardless of what I do topically, and the amount of black facial hair I have has more than doubled. All my acne is on the lower half of my face - many hard plugs (Keratin? Sebum?) and also large, deep painful pimples that do not surface.

• I got a battery of hormone levels tested and all were within normal range, though I know that this wouldn't reveal any hormone sensitivities if I have them. I did have an ovarian cyst a two years ago that went away on its own, and had an 80-day gap between two periods this year. Needless to say, something isn't quite right.

None of the docs I've seen (2) have suggested or agreed that PCOS might be the issue here, and I can't think of anything else. Should I see a dermatologist? Endocrinologist? Gynecologist? What could this be and what would the treatment be? Spironolactone? Hormonal BC?

Thank you! <3