Getting fed up please help

So a little backstory I used to have perfect skin. Like literally never broke out, maybe one pimple RARELY here and there. The kind where I wouldn’t wear foundation I would throw on some highlight and mascara and call it good. All that changed in my late teens when I switched from hormonal birth control to my non hormonal IUD for health reasons. And over the next few years I started noticing that not only would I get horrible breakouts before my period but I have either acne scars or hyper pigmentation that NEVER goes away. I’m going to attach pictures. I need help. Should I do proactive, curology? See a dermatologist?? I feel like I do everything right I drink a gallon of water a day (no exaggerating) I take probiotics every day, I eat gluten and dairy free and very healthy, I workout. I have a 8 step skin care routine that I do every night. I’ve tried tea tree witch hazel apple cider vinegar charcoal salicylic- nothing helps. If you can give me some advice it would be greatly appreciated. It’s depressing because I never used to wear makeup and now I can’t leave the house and am SO self conscious without it 😔

It looks worse than usual because I’m literally going to start bleeding any second but its not much better than this the rest of the month. Even when my breakouts seem semi under control the scars are always there.