Hormonal acne

So, I'm having issues with breakouts and Seems like nothing I do works or only works temporally and it comes back. It's always on my chin, and usually week before my period so I know it's hormonal. I've tried everything from antibiotics, creams from the derm, (which I use retin a right now for about 3 months)and am on spironolactone for 8 months, tried birth control for two years and nothing! I workout 3-5 days a week and eat relatively healthy and drink tons of water! It's definitely not severe but it's enough to be annoying, and it's sometimes even painful 😩 anyone know of anything that could help?! I'm stuck and sick of googling ideas!!