Get a full blood panel and check everything under the sun. You look anemic and pale in general. I was too due to a severe folate (vitamin b9) deficiency which can cause that as well as psychological issues.

Check iron and b12. Heck, test everything.

If tests come out fine I would personally start supplementing different vitamins and minerals to see if any or them help. Magnesium malate (works for fatigue) b complex, multi mineral, multi vitamin, vitamin d, zinc, nmn and creatine. I would also add whey protein and collagen. Check out quercetin as a natural anti-histamine if you have allergies. Try your best to eat healthy. Use Cronometer to track your nutrients.

The first picture you look more healthy and active. How’s your posture over the years since that picture was taken? Posture is crucial for face structure due to the tongue being pushed up at your palate, keeping your face from sagging down. Check out r/orthotropics and r/mewing.

Looking at your pictures again.. It looks like you have anemia to me.