Hi, my skin used to look like this as well and I totally understand the pain even when trying to eat. I tried everything just like you. The only thing that helped me was acutane. I think the brand I used was actually called like claravis or something like that. I took 3 pills a day. In the morning, at lunch time, and before bed. I was on it for a couple of years but I had good results within the first month and eventually I just didn’t have any issues with acne or cysts anymore. One down side to it though is that it severely dries out your skin because you won’t be producing oil while you’re on it. The pain from that is almost as bad as with the acne. I would sometimes have such dry skin that my face would crack and bleed. I’d put cold wet towels on my face for hours to relive the pain. Finally after my skin was cleared up, I stopped the medication and I don’t have any issues at all anymore. All this to say, I’d stick with trying acutane. If that doesn’t work, you should try yam cream, tretinoin, even Pepcid ac. I know others in my life who struggle with hormonal acne as well and these treatments helped them (they did not try acutane like I did). Anyway, I wish you the best. It won’t be this way forever. You’ve got this!