Have you had yourself tested for food allergies or food intolerances? I had lots and lots of issues with acne/my face breaking out. When I got sick at the age of 40 (still breaking out just terribly; used the strongest Dermatology pharmaceutical drugs there were), I went to see an alternative doctor. Not only did that doctor make me go off all nonessential pharma drugs (I was on 12 drugs; took me off all but 2 drugs), she also tested me. I found out I had casein allergy and a severe intolerance to gluten and soy.
Now if I stay away from/don't consume foods made with those ingredients, I am fine. If I get naughty and eat one of them (or something with one of them in it), I will break out on my face, neck, or back.
Remember: The skin is the biggest detoxifying area of the body. If your body is trying to get rid of something (say, you ate something your body doesn't like and it is "detoxifying" itself), it's a sure bet that the detoxification is going to be through your skin. Some people have facial acne issues. Others suffer from psoriasis (sp) on other parts of the body.
I also switched over to organic food, got rid of junk/processed foods in my diet, drink reverse-osmosis water, and try to make sure I get enough sleep (I'm still working on getting myself motivated to exercise frequently, but that's next on my list.).
If I stay away from the foods that offend my body, my skin clears up and I don't have to use anything, not even anything over-the-counter.
However, for those one or two acne bumps I get, I like to use Burt's Bees acne serum. Works like a charm!