Hormonal acne and treatment options.

Hi guys. I have been lurking in this community for quite some time but this is my first post. Growing up I had regular acne that every kid has in puberty but it transformed into horrible cystic acne when I was 18. It was limited to my cheeks and looked more like acne rosacea. I also had hair loss and extreme weight gain in my hips and thighs. I had gained 20 kgs and I was eating healthy. I am 23 now and have managed to lose some weight. I am looking to tackle acne next. My acne has kind of changed. Now I get cystic acne along my jawlines.I have never been on birth control and I am kind of scared of it because of my other issues specifically weight gain. I also have a history of anxiety and panic attacks. I also got my ultrasound done and ovaries are normal. I think one ovary has 7 follicles and the other had 5. I also got my blood tests done. Testosterone is on the lower end of the spectrum and free testosterone is on the lower end. I had high DHEAS and my estrogen was off the charts.i had high prolactin as well. It was very high. My fasting insulin was 12 and thyroid panel was normal too. I do think that I suffer from estrogen dominance and that does impact my thyroid. I do have a family history of fibroids on my mom's side.

I also suffer from horrible anxiety for 10 days prior to my periods. Most of my cystic acne sprouts in my ovulatory days and I really am looking for ways to tackle it.

Current I use topical azelaic acid, Alpha arbutin and glycolic acid. It's not helping. I tried applying tretinoin last year but my eyebrows started falling out.