Hi @Kelly  acne has many contributing factors, including genetics and hormones. Hormones as you alluded to commonly lead to acne in the teen years due to changes around puberty. That aside, hygiene and diets high in processed, suger-rich foods have also been highlighted in the medical literature as contributing causes.

It sounds like you have already adopted extensive hygiene measures, and as for diet, keeping well hydrated and minimising consumption of processed, suger-rich foods like bubble tea would be beneficial. There are several prescription medications that are vitamin A derivatives which can certainly help, however they have some considerations such as not being safe for individuals trying to get pregnant. Ultimately, given the extent of acne and scarring you describe, you may want to visit your GP for a review and detailed discussion about these potential oral treatment options that may help get the condition under control.  Hope this helps!