Tiredness will require blood tests for thyroid function tests and hormonal blood work.
The factors that directly contribute to acne are:
1) excess oil production,
2) pores becoming clogged by “sticky” skin cells,
3) bacteria, and
5) hormonal issues
6) hereditary factors.
A 20% azelaic acid cream is very effective.
A prescription of tretinoin (Avita, Retin-A) will also help.
Avoid fatty and fried food.
Drink plenty of fluids.
Fruits and vegetables and healthy food would also help.
1. Please avoid any oil-based cosmetics --water-based is better.
2. Please use a salicylic acid-based moisturizer daily in the daytime ( Cetaphil for example).
3. Please use a soft soap like Dove sensitive skin
4. Use Adapalene 0.1% gel daily at bedtime to reduce inflammation and regenerate healthy skin. This is over the counter.
Most likely you have androgen sensitivity.
Hence, anti-androgen therapy with prescription medication Spironolactone 100 mg daily for 3 months will clear up skin faster.
I wish your symptoms resolve soon.
I would be happy to assist you further if you need any more information.
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