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Hormonal acne

This has been plaguing a friend of mine for years. She is in her early forties and it is getting down mainly on chin horrible and painful spots
chin, horrible painful spots.
Had three courses of roaccutaine in the past which helped. We are running out of idea what to do. GP will not refer back to dermatologist as do not think it is bad enough. Other option to go private but who shall she see, dermatologist, nutritionist or Chinese herbalist. Pl can anybody advise . Thanks
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