Are these acne scars, sebaceous hyperplasia, EVHC, fungal acne, etc? (Photos)

Determining the exact cause of textural irregularities on your cheeks can be complex, and it's important to have a thorough evaluation by a dermatologist for an accurate diagnosis. However, based on your description, here are some considerations:

Sebaceous Hyperplasia: This condition involves enlarged oil glands, appearing as small yellowish bumps. It's possible that some of the bumps you describe could be sebaceous hyperplasia. Treatments can include topical retinoids, laser therapy, or electrodessication. Accutane (isotretinoin) may help in reducing sebaceous gland activity but is generally reserved for more severe cases.

Acne Scars or Textural Changes: Even without major cystic acne, clogged pores and blackheads can lead to textural changes over time. Treatments like microneedling, laser resurfacing, or chemical peels could be more effective in improving texture.

Fungal Acne (Malassezia Folliculitis): This type of acne is caused by yeast and can resemble regular acne but often requires antifungal treatments rather than traditional acne treatments.

Treatment Evaluation: Since you've tried various treatments with limited success, it might be beneficial to reassess your skincare regimen and consider a combination approach. Sometimes, a series of treatments is needed to see significant improvements.

Consultation: I recommend discussing these possibilities with your dermatologist, who can assess your skin condition in person and recommend the most appropriate treatment plan. If sebaceous hyperplasia is confirmed, they can discuss whether Accutane is a suitable option for your situation.

A personalized approach based on a detailed evaluation will likely yield the best results.