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probably very high estrogen and DHT levels, both of which can cause acne in men.
Use an AI at the very least. Personal hygiene helps to take you a long way despite having high DHT/estrogen. Wash your sheets and pillowcase often. Wash your face with a good cleansing soap 3x/day. Shampoo your hair and wash your hands often. Avoid rubbing your face. All the stuff we learned (and forgot apparently lol) during puberty to keep ourselves cleanish.
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