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

Hey y'all! 26F, 5'8",124lbs, USA. 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. Body hair going wild.

• 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. I spot old blood after penetrative activities.

None of the docs I've seen (2) have indicated that PCOS might be the issue here, nor have they suggested what I can do or referred me to anyone. Should I see a dermatologist? Endocrinologist? Gynecologist? What could this be and what would the treatment be? Spironolactone? Hormonal BC?

Thank you! <3