adult acne, hormone affected

Hello,

I'd like to ask for your suggestions in treatment of my continuing acne.

My acne started with puberty. I used antibiotics and prescribed creams that did clear my skin up for a few years, but I eventually stopped using them. Different creams and washes haven't resolved the problem, nor has time.

I drink home brewed kombucha, which seems to have some benefit. Taking burdock tincture didn't make any noticeable difference.

I am 27 years old, wash my face well twice a day. My acne is mostly vulgaris, and relatively mild. It's most common on my cheeks, the corners of my mouth, chin and temples. My skin is fair, but oily in the t-zone. It's worse around the time of menstruation. Menstruation is regular, but on a 23 day cycle, not 28.

I do have some scarring, not severe, red pocks marks can take weeks or more to clear. I attribute this to low clotting factor levels.

I don't drink enough water, though staying well hydrated doesn't fix it either. I prefer warm climates. I keep a balanced vegetarian, mostly vegan, diet with limited oils. I'm physically active and healthy. I am susceptible to depression, and do have stress in my life. I'm a restless sleeper.

I'd appreciate your suggestions, and am happy to provide more information if needed.