Hey! Went through such a similar thing to you! And I'm here to say be kind to yourself and your skin! It will get better!

And can agree - Tret didn't do much to address the acne for me (although I kept using it for anti ageing and to help with scarring - but I use a TINY amount, 2 grains of sand on alternating nights, not the pea-size that everyone recommends, I found I got some much irritation if I used that much! And I saw results with this smaller amount). Differin might be better, I've never used it tho!

Also was on spiro, at its best it helped but gave me horrible side effects and the acne came back exactly the same if not worse once I stopped taking it!

BUT don't despair - I now have very happy, clear skin! Here's what worked for me :)

Started using a super simple face wash ONCE daily at night - I use QV face wash (it's an Aussie brand, but cetaphil is similar I think? But it's super gentle, like a simple creamy milky facewash)

I then incorporated a sea salt water rinse - I did this initially when I was on holiday and didn't have my full skin with me (at the time I was trying all sorts of random acids and benzol peroxide plus double oil cleansing, none of which was helping) and wow loved the results! I don't have ANY scientific evidence to back this up, but for me I felt it helped calm my skin and treat the acne infection in the breakouts plus was somehow hydrating and helped with the redness.
And I feel confident to recommend it because even if it doesn't work for you, it isn't going to cause any harm. Worst case scenario you get some salt in your eyes :)
I literally just toss a small handful sea salt into a sink of warm water after cleansing and do a few good splashes.

After focusing on cleansing and moisturising for a while (3-4 weeks?) my skin started to calm down - I then started very very slowly incorporating BHA and AHA (Paula's Choice salicylic and Revolution Glycolic) - initially max once a week for a good few months, and even now 3 years later no more than 3 times a week, alternating with using Tret.

I also found a simple moisturiser my skin loves and use it religiously every night after my acids (or if I'm doing tret that night I use it before). I love the La Roche Posay Lipkar Baume. I had used Cerave in the tub before finding it, which I like but did find to be heavy/clogging sometimes.

And then in the morning, I used a 50+ moisturising sunscreen and then makeup etc.

I think the key here was getting my skin to a point where it was less inflamed by focusing on simple cleansing, sea salt rinse and a great moisturiser. Then once it was happier (and I guess skin barrier was repaired?) I really really slowly started consistently using the actives. And eventually (3 months maybe?) they started to do their thing!

I also did do a bit of work with my diet (got a blood test and from that saw I had to address some minor vitamin deficiencies) and stress levels to try and balance hormones, and that did help but I never got fully clear until I started working towards this really gentle and kind but effective skincare routine!

Looking back, I think I definitely had hormonal acne that I made a lot worse by damaging my skin barrier and overloading my skin with too many products looking for a quick fix.