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I can confirm from personal experience of a very moderate acne problem that it need not have anything to do with diet or hygiene.
As with any manifestation of dis-ease in the body, the origin relates to emotional imbalances.
While I may not be able to pinpoint the exact thought complexes that trigger it, I have found that depression and stress were the main factors to trigger an outbreak for me. It may, however, also be structured as an emotional build-up in conjunction with depression, whereas depression could be the keystone that leads to the physical eruption. Because when we experience depression, we are in resistance to the source energy that vitalises our being, which, when restricted in any way, is why dis-ease occurs in the first place. It would then seem that the body locations of the acne could relate to the nature of specific thought patterns, where for instance confidence and self-image relates to meridians running through the face, while heart ache and sorrow relates to meridians running across the shoulder blades.
My advice for you would be to accept and learn to live with it as it is. If you struggle with self-love issues, you may want to work on this. Do also your best to eliminate any source of stress or depression in your life. All of these will help you alleviate the problem to a significant extent.
Another thing you can do, particularly to help you with emotional struggles, is to look up a video on YouTube titled "The Pulse Technique" by Deb Cummings. This video features an energy transmission that will address any issue of your focus, to progressively clear it away from your life, until it eventually has permanently eliminated the root cause.
Write a list of subjects that bother you, and give them one or two sub-points to address your most early memories and the most distressed experiences. Then use the healing transmission repeatedly to address one item at a time.
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