Hi I have acne on my face mostly blackheads whiteheads

Patient : Hi I have acne on my face mostly blackheads whiteheads and yellow painful pimples sometimes boils. How do I know if its hormonal or bacterial ? I'm 23 also in the past my skin was perfect this has been going on for two years and started during a summer with a little itchy pimpley rash under my neck and started slowly spreading up the sides of my face. I have tried sunbeds, washes, duac acne cream, not washing it, and alternative treatments it gets really itchy sometimes. I have pictures also I can show please help currently my doctor is refusing to send me to dermatology .
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