Acne has a plethora of causes, diet, lifestyle, cleansing routine, sebum production stress, hormones, exercise, and probably more
That's why it's so difficult to pin point a single cause and why people believe diet dosnt make a difference, it can make a massive difference just not alone
i know you mostly have but...
Quit dairy
Quit sugar
Quit grains
Get exercise
Stop pummelling your face with harsh products
Relax, meditate, stress exacerbates the problem
Know that lifestyle changes will help you big time and that acne is not only an internal problem but also a hormone-related one too, sorting out your lifestyle will balance your hormones and make a huge difference, spot cream was invented for the lazy who eat poorly and dont look after themselves, and it works (poorly) by damaging your skin in the long term
Also, as difficult as it might be to believe, not washing your face is possibly the best route to take, just with water, try the oil cleansing method, putting something like olive oil on your face at night will send signals to your body to stop producing sebum which is what mostly causes spots, I do it and it works amazingly well, it also nourishes and hydrates your skin about a million times better than any synthetic man-made concoction will, remember you shouldnt put anything on your skin you wouldnt put in your mouth, would you eat accutane? probably not!
Finally, dont believe that anyone cares about you. The people who make acutane wants you to buy their products, so do clearosil, so do the doctors to an extent
If man made it, don't eat it