What do you typically eat in a day?

Soy is a common ingredient in vegan foods, it's also a phytoestrogen which the body can confuse for hormones. Consumption could cause hormonal imbalances as your body is tricked into thinking that it has enough of a certain hormone when it doesn't. Do a quick google search on the relation between soy and acne.

A lot of people also find that grains can lead to acne. As a vegan I presume you eat a fair amount of grains to compensate for other foods - have you increased your consumption of these? If so - maybe try cutting back or even completely just for a week to see if you notice a difference.

Unless you're strict with supplementation, vegan diets can also lead to malnutrition - where your body isn't getting the variety / amount of nutrients it needs. It's not easy to meet all your needs when you cut out nutritious food groups. It may be worth incorporating ethically produced/sourced animal products back into your diet for the short-term to see if they help, although if it was a moral decision then don't worry. Try looking into calcium / magnesium / zinc / vitD / omega 3 supplements - as it's not easy to get sufficient levels of these through a vegan diet alone.

One problem with acne is that the initial breakout can create a cycle which is hard to break out of. For example, you have more spots so you pick at your skin more, or the appearance of spots causes stress which in turn leads to more spots... you need to try and do what you can to break this. For starters, give yourself a week or two of not going out, and if you're embarrassed to explain to friends just say you're ill - this should help with the stress / guilt of making excuses all the time. If you can, find someone to talk to about how you're feeling - whether it be parents, a sibling or a friend... even if you can't face them, maybe talk over text or phone and just explain how much it's all getting you down. Even if there are a lot of people who you're 'living a lie' to, it's important to have someone that knows the truth and you can talk it out with.

Try not to look in any mirrors during your 'time off', as you'll probably end up picking and making your skin worse. When I started breaking out a lot I used to wash my face twice as much as I did previously... but over-washing your skin can dry it out and cause your body to produce more oil to compensate (as the acne infections often occur around the oil glands, a sudden increase can result in more spots), so try to wash your face just once or twice a day with cold water and lightly wipe with a wash cloth. Chemical face washes can aggravate skin problems so if you can avoid these. They're not at all pleasant but taking cold showers rather than hot can also help. I'm guessing from what you've said you're not really going outside... the sun can really help your skin, on a scientific level (uv light has been shown to kill skin bacteria, and your body metabolises vitamin d3 from the sun), and also by giving you a tan... if you're pale this will make the acne contrast less with your skin - if you have a private garden / yard, maybe try and get an hour of sunlight a day rather than sitting inside.

The damage stress can have on your body is real and completely underestimated. When you're stressed out, your body activates the sympathetic nervous system. It can be beneficial for some activities in the short term, such as playing sports or slightly less common... running from a predator - but if you're constantly stressed which you clearly are, it hardly ever switches off. This can lead to an overproduction of insulin, which has been proven to increase oil production in your skin - resulting in the formation of acne. One way you can help address the emotional (and physical) stress is to try meditation. I'm the biggest sceptic I know, and I thought it was all absolute quack - but it really does help. Try going onto YouTube and looking up 'Deep relaxation guided meditation', pick a 20-30 minute video, get some headphones, find somewhere quiet and just follow the instructions. It's just slow deep breathing for the first 10-15 minutes or so but there's a point where you feel a sense of weightlessness and absolute calm. It really helps you to relax and helped me a lot when I was struggling.

Major props for deciding to look for the root cause of your problems. Your skin is one of your major detox organs, and after years of research i'm 100% convinced that acne is your body's way of telling you that something is wrong. Accutane basically shuts down your body's ability to detox through the skin by damaging your oil glands. If your body can't produce oil then the acne infection never occurs... but chronically dry skin aside, it means that your liver and kidneys are handling the task without help from your skin.

I've reached a stage now where I can identify what's going wrong in my body and address it based on the appearance and positioning of spots - which always leads to the acne going away. I know how debilitating it can be and I really hope you can find a solution.

abcdef123456 has pretty much ended the thread. Print out that post and hang it up.