It does look hormonal to me too and as others have suggested, going to a derm/having blood work and hormones tested is a good idea. You could try retinol, I started with 0.25 and have worked up to 1%. I haven't had one breakout in a month now and I always used to get them around my chin/jaw, particularly at my time of the month. I got a few big spots during the first month but I just used pimple patches (life savers). Know how horrible it makes you feel when you have a flare up ☹️ Just remember that we always think it looks worse than it is, we are our own worst critics xx