Skincare help!

[Rosiee29]

Hi all,
I am 25, having trouble with my skin and need some advice please
I have lovely skin in general, however I seem to constantly have a few big, painful, under the skin pimples along my jawline and lower cheeks. My nose and chin are also always congested with sebaceous filaments /small blackheads. Nothing I do will get rid of them! I have tried oil cleansing as recommended but it doesn't help.

I don't wear full face makeup, just a little concealer here and there. I wash my pillowcases constantly and have 4 pillows on my bed so use a different one each night. I am scrupulously clean with my hands and my phone as I know these can also transfer bacteria

This is my routine
Morning : cerave hydrating cleanser
Niacinamide serum (life saver!)
Cerave moisturiser
La Roche posay SPF

Night:
Cerave hydrating cleanser
Niacinamide serum
Cerave moisturiser
Tretinoin 0.025%

I use the tretinoin every other night and I don't get any irritation. This is the best routine I have ever had and my skin has made leaps and bounds with the tretinoin but I can't seem to shift these big spots and congestion.

I have read this may be hormonal, if so, would taking the pill help this? Any advice welcome, thank you!

Have you tried double cleansing (e.g. using a balm cleanser like Clinique Take the Day off and then your Cerave cleanser)? And what about an exfoliant - I like REN AHA tonic or Alpha H, but Paula's Choice BHA might work better for your skin.

Yes. It’s hormonal. See GP. Dianette and Yasmin contraceptives usually work well for this type of acne.

Topical treatments can sometimes be enough. Personally I’ve not found tret to be that effective for acne and can make it worse as irritates the skin (And tbh you really don’t need it at your age)

Niacinamide gives me the deep, painful under skin spots

OP you might be better to switch from tretinoin to adapelene (also called differin), I'm not sure if you need a prescription, I think it maybe in Boots in the UK.
It's very similar to tretinoin but more suited to acne prone skin, plus tretinoin is more for anti aging which you don't need at your age.