I've had cystic Acne for 40 years. Though it has fluctuated, it has always been there, except for the short period in my 20's when I foolishly took birth control pills - another clue to it's hormonal basis.
Immediately after starting th saw palmetto, there were no more new pimples (tho the old ones are still fading; mine stay FOREVER!) NO initial breakouts, unlike with de-tox.
I always considered it a "man with prostate cancer" thing, but I have been desperate to find help. So I put 2 plus 2 together. Testosterone can be out of balance with women also...have you any other testo symptoms, such as high libido and quick temper? It's certainly worth a try; supposedly the calming of the inflammation factor is also helpful in warding off prostrate and breast cancer...don't know how true that may be, but it doesn't seem to have side effects. Good luck.