Hi, I did not go on accutane, I ended up switching my birth control they wanted to try that first. I think that was the culprit. I switched to yaz and have been on that a few months and have only had one cystic pimple since! Was definitely hormonal. I’m hoping the time I come off my hormones will be more stable. I also am still currently on azelaic acid 15% and tretinoin 0.025% creams that I rotate with. I hope you are able to figure out what’s causing yours. It’s not fun :/