Brief Answer:
Overall consideration & management under endocrinologist/ skin specialist.

Detailed Answer:
Hi XXXX,
Thanks for your query under HCM.
To have acne on face hampers looks & hampers confidence/carrier making in today's age of competition.I understand your concern.
* I observe that you have multiple health factors assisting acne ..& each one needs to be taken care of precisely to have good effect on Acne control.
You are already a Diabetic on Insulin, Have low thyroid levels being controlled by thyroid pills -- Both the conditions are known to cause hormonal imbalance & thus cause flares of Acne
You also seem to be psychologically depressed ( taking Paxil)
* I would advise a detailed review with investigations to assess control over both conditions ( Diabetes & hypothyroidism) with present medications-- & revise the dosage if needful with your treating endocrinologist.
- Both the conditions cause hormonal imbalance-- causing condition like PCOD / irregular periods/ acne. The hormonal assay would help in pin pointing the causative factor & specific replacement/ adjustment ( like with combined oral contraceptives) will be possible thereafter.
* management of acne by a skin specialist with antibiotics, retinoids, personal care like frequent face washing local ointments as peer doctor's advise / having low caloric, protein & vitamin rich diet/ use of antiseptic soaps .
** i am sure an overall treatment of acne along with faith in treatment & positivity( achieved by self efforts- meditation/ counseling) would defiantly help you in getting rid of the problem.
I hope the answer was both informative & helpful to you any follow upy is welcome.
Thanks.

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