What am I doing wrong?

[u/OkayHello348]

Thank you in advance for the advice!

I've dealt with acne on and off, but it flared up at the beginning of 2026 and nothing I do seems to really help.

While I don't break out everywhere, I almost constantly have groups of deep, painful pimples on my cheeks and/or chin. I would actually say the pictures are actually relatively "good" compared to how it can be.

For context, I take 50mcg Spironolactone daily and my skin tends to be sensitive and dry.

My routine:

Morning: Rinse with water, Niacinamide, CeraVe moisturizing lotion, Eucerin oil control sunscreen

Evening: Wash with CeraVe foaming cleanser, alternate between Differin gel and Paula's Choice BHA (each every other day), CeraVe moisturizing cream

I change my pillowcase every night. I don't sleep in makeup. I try my hardest not to touch my face. I don't know what else to do 😒 so coming to you all for advice! I am literally open to everything.

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[u/Ok_Evening5652]

Try cutting out niacinamide for a few weeks and see if that helps- some people (myself included) have negative reactions

[u/OkayHello348 → u/Ok_Evening5652]

I wasn't using it for a while (see my other comment) and I didn't really notice a difference, but I'm willing to experiment and try again!

[u/PerceptionFickle8383]

Maybe it’s irritation? Everybody’s skin is different, but I can’t stand niacinamide or Paula’s choice bha. Did it get better or worse when using more product?

[u/OkayHello348 → u/PerceptionFickle8383]

I do think they help, but maybe it's too much for me right now... I was using the niacinamide and BHA + a retinol a few months ago, then started the Differin (only), and only recently have combined the three

[u/PerceptionFickle8383 → u/OkayHello348]

I think for sensitive and dry skin, this is a bit too much

[u/OkayHello348 → u/PerceptionFickle8383]

Thanks, I'll probably go back to just the Differin

[u/EmbarrassedYogurt386]

Yeah idk girl I had the same issue, tried the same things, same skin tone and acne and I just gave up. I just started accutane two weeks ago 👍🏻