Sorry, a little late to the game . . . I am PCOS likely and have been under acne care by a dermatologist for the last 17 years! Some of my success came from not playing catchup and I’m not sure what prescriptions you’ve been given, but I’ll put in my routine. All products excep the Peter Thomas Roth ones were recommended by a dermatologist at one point or another. I only wear eyeliner and mascara daily, so I haven’t figured out friendly make-up products.
Morning routine (I shower at night):
Wash with Cetaphil daily facial cleaner, pat dry, apply Benzaclin, let dry, apply Neutrogena Oil Free Moisture SPF 15 (you have to have SPF with all these meds).
First of all, Benzaclin is magic. It’s expensive and expires every 3 months, but it’s a combination of Benzoic acid and clindamycin that was developed maybe 10 years ago and it is GREAT at prevent/stopping breakouts. It also bleaches the heck out of all fabrics, so use white sheets and towels. I apply benzaclin morning and night, even though the original guy told me just to do it in the morning. You can also spot treat on bad days. If this product hasn’t worked for you in the past, I’m truly sorry.
Night: Wash with Neutrogena Oil Free Acne wash (salicylic acid) in the shower (it’s very foamy, not great at other times because it gets in your hair). Sometimes I exfolliate with Peter Thomas Roth Botanical Buffing Beads (harsh stuff isn’t great since my skin is so medicated). I make sure to wash with regular soap or exfolliate after applying conditioner to make sure there’s no conditioner on my face. Out of the shower, I apply Benzaclin, then Differin Gel. Differin is similar to the Retinol product and is meant to prevent breakouts. Differin is a newer product than Retinol and comes in different strengths that you’ll just have to work with (can really dry you out). Then I use Moisturel as my nightly moisturizer (only found at CVS or Walgreens or places like that). It’s non comodegenic, hypoallergenic, well balanced etc. Not a facial cream, but truly the least irritating lotion I’ve ever found.
One thing – be very very careful where/how you apply everything. I ended up with a skin allergy from applying Retinol to my neck and back. If it’s not working, go get something else, don’t glob on =/. Your skin may become more sensitive, so you may have to move to Dove soap (gentler than real soap), fragrance free/hypoallergenic stuff. But your skin will look great lol.
Also, when my prescriptions run out sometimes, I get an over the counter benzoic acid (currently using a Clearsil Rapid Action Vanishing Cream) to replace the Benzaclin. Differin usually lasts forever, so I’ve only run out once. When I run out, I start using masks like crazy in addition to exfolliating every day and making sure I have salicylic acid washes.
The mask I prefer (mostly because my skin is so chemically treated I’m usually using it to calm things down) is Peter Thomas Roth Cucumber Masque. It’s horribly expensive, so if anyone has a recommendation for an alternative, I’d love to hear it!
Finally, I just purchased an Aveda toner that I’ve used a few times since I’m nervous about it reacting with everything else. It kills oil magically in the middle of the day, so it’s good for really oily days when I can’t rinse off my skin.
If you use makeup, maybe some of the Almay stuff with salicylic acid in it would be helpful, but I generally find salicylic acid to be overhyped. And whatever is in the clindamycin part of Benzaclin is really really helpful on top of the Benzoic acid. Over the counter benzoic acid burns, but Benzaclin doesn’t.
Worst case scenario are chemical regimens like the antibiotics people talked about. There’s another really harsh regimen I can’t remember the details of except you must be on birth control because it causes birth defects. But after a year, you supposedly are free and clear forevermore. A family friend went this drastic in her mid-20s and her skin is now great.
I hope you can find a dermatologist that will work with you! There are so many steps and so many products out there that I’m sure you can find something for you. Sometimes even changing the order you do things helps.