As is the case for many people who wage the war against acne outside of the 12-to-20 age bracket, synthetic hormone injections are only one of the many questionable methods I’ve relied on to keep my face looking more like my face and less like the Lady in the Radiator from Eraserhead (google it). In the past five years, there have also been harsh topical treatments (accompanied by strongly worded warnings against use during pregnancy), three different types of birth control pills, and even an ill-advised yearlong stint on the antibiotic tetracycline — and always some combination of one or the other, because there’s never just one thing that makes a difference for my difficult-to-treat brand of hormonal acne. Sometimes, the stars align and my skin ends up clear for a precious moment, but chaos always awaits me just around the bend.