What are the ways to treat acne caused by oily skin?

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I understand your concern. I looked over the image (attachment removed to protect the patient's identity). It is acne vulgaris Grade 3. As you mentioned, acne usually appears due to multiple factors, including hormonal changes, climate changes, dietary imbalances, genetic factors, skin products, and gynecological conditions like polycystic ovary syndrome (PCOS), which often presents menstrual irregularities. But sometimes menstrual cycle may be regular as well. Therefore, to rule out PCOS, my advice would be to consult a gynecologist in case of menstrual irregularities. To manage current acne, however, I suggest taking AHA glow S (Salicylic acid 2 % and Glycolic acid) foaming face wash which is easily available online. Apply twice daily, massage gently in a circular motion for one minute, and wash off. For two months, use Peroclin gel 2.5 % (Benzoyl Peroxide 2.5 % and Clindamycin 1 %) in the morning after cleansing the face with a face wash and applying it to acne lesions. Aziderm 10 % (Azelaic Acid) cream is to be applied in a very thin layer on the affected area on alternate nights. Make sure your face is cleansed and dried well. Your hands and face should be absolutely dry without any moisture. Apply the cream in a pea-sized quantity only on the affected areas in a very thin layer. Please do not use it all over the face and do not use it in large quantities since the medication is strong and may cause irritation. Take tablet Ascorbic acid (vitamin C) chewable 500 mg to be taken after food twice daily for two months. Avoid sweets, oily and fried food, milk and dairy products, and red meat. Consume more fruits and vegetables, and adequate water intake is advised. Gynecologist consultation is advised, as mentioned above, to rule out PCOS as, without eliminating the root cause, the management of acne may be time taking. Acne may be on and off depending on hormonal changes, climate, and dietary changes. External factors like diet can be managed. However, hormonal factors being internal may not be managed. Therefore, management of acne may have to be done frequently till the acne lesions lessen in appearance. For this reason, consistency is key.