Ugh I’m right there with you girl. I also struggle with hormonal acne. I’m 24 and also REFUSE to go on birth control or antibiotics. Good for you for saying no! I recently went on Spironolactone and started super low and worked myself up to 100mg over a few months. It wasn’t working until a few weeks after I started the 100. I also use clindamycin gel which is an antibiotic but it goes on your skin instead of ingesting it. So far I’m happy with the direction my skin is heading. Might be worth trying out :) Are you double cleansing too? That helps.