how did you start getting acne..? i mean was it hormonal...or bcz of a skincare mistake? or nythng else?
myn was due to coconut oil which you are using right now

It was hormonal. Puberty
I have had my hormone levels checked and other than my test being a tad high, estrogen is normal

Have you ever been tested for food allergies/intolerance? For some people it can go beyond dairy, wheat and sugar. A male friend of mine who has IBS, he cannot tolerate spices of any kind, or too much fat or he gets cystic breakouts. Some people only show their digestive troubles through their skin, have you ever tried a gut-healing diet like the GAPS?
What vitamins do you take? Some can make acne worse (B12 (especially when combined with B6) Biotin, fish and other omega oils disagree with some people, iodine etc.)

Yes I have done allergen testing. My diet was assessed and established by a dietitian way back in my early twenties. It was called the caveman diet
the name and terms have changed but it is pretty close to the gaps diet.
As for vitamins, I take Quest multi vitamin with no extra added VitB complex.
Vitamin C and vitamin D for the winter months.
I learned the hard way long ago about Vitamin B's when I was trying to combat the hair loss brought on by the Accutane

Do you consume any caffeine? Even a little bit (as In one tiny white tea in the morning) can cause some people to erupt.
Have you tried probiotics?
Unfortunately I'm not very familiar with male hormones, excess testosterone can cause acne for women, does this apply to men as well? I'm not sure if its safe for men to lower their testosterone, but maybe you could try some supplements that stop the conversion of testosterone to DHT, perhaps just in lower doses than a female would take.
If all physical loose ends have been tied so to speak, then perhaps you could try your emotional health next. I don't want to get all freud on you but do you have any persistent underlying emotional issues that are suppressed or unsolved? Are you happy? Do you have healthy relationships? I don't expect you to answer these on here but just something to consider.

Going off of what dfitz said I have a friend with excess testosterone and he has to be on his meds or else he gets terrible acne and hair loss. I know you said you had your hormones checked out and nothing was too alarming so maybe its not the testosterone

I know that its really frustrating when it feels like youve done and tried a lot of things, but Im going to just put down a list of things that you might want to consider (sorry if they sound stupid or repetitive I dont mean to offend you in any way).

- Go to an endocrinologist and get things check out. Having your endocrines off by even the smallest amount can wreak havoc on your body.

- Go to a GI and see if you have any mild, digestive issues (IBS, IBD, Chrones, UC, etc.) that might be putting stress on your body.

- Have you had a series of seemingly innocuous stressors? It can be something as stupid as moving from the city to the suburbs (where there might be a lot more pollen), becoming a new uncle, getting a knew shampoo, needing to get your car fixed, etc. They all seems stupid separately, but if you have these things happening one after another, youre creating a prolonged time of stress

- Id also look into your diet again. From the info you provided, this diet plan was made for you about 10 years ago. Although the cavemen diet is one of the more reasonable diet out there, it is still cutting out grains and a lot of fruits. Cutting out food groups like that always increases the risk of missing out on vital vitamins, minerals, enzymes, etc. that you cant get in convenient pills. Its very possible that you had a sufficient storage of X to last you the last 10 years but you may have exhausted the supply by not replacing it through diet.

- Id also get reassessed for food allergies and tolerances if you can; its not uncommon for people to develop new allergies or lower tolerances to foods that they were find with just a couple years ago. For example, I was completely find with melons for years and out of nowhere, I developed oral allergies to them and my mouth starts burning/itching if I eat them.

- Not hating on nutritionists or doctors or dieticians or whatever but keep in mind that they are still human and humans have a tendency to make decisions based not solely on facts but their own beliefs. For every group of nutritionists and doctors that support XYZ diets, you will find another one that sees the diet as being terrible for your body. Oftentimes they both have good points its just a matter of what aspect they prioritize as being the most important/beneficial/harmful.

- Keep in mind that a lot of these diets, lifestyle changes, regimens, etc. are made for the general public. Something that has no adverse effects of most people doesnt mean youre immune to it. I had a friend who converted to vegetarianism; she did all the right things, but she developed rashes everywhere. After going to multiple doctors, the only thing that couldve caused that was her stopping consumption of mean. As soon as she added meat back into her diet, her rashes started disappearingmy point is, you dont hear about no meat = rashes often. Thats why my friend and multiple doctors never suspected it to be the culprit of her rashesMaybe keep a log/list of things that you are in frequent contact with whether it be a type of cloth, food, drink, cleaner, etc. and see if your acne flares up or down according to it.