Wishing you the best of luck with this awful disease. Sadly, I don't have any suggestions. I am a 48 year old female, battling acne for well over 25 years now... I was on Accutane about 15 years ago. Since then I've been on Doxycycline, Oracea, Spironolactone, everything over the counter, everything 'natural', hormone testing, gone sugar free, dairy free, gluten free, etc...  Several months ago I had food sensitivity testing done, and it was very eye opening! Several things that I would have never considered to be a problem for me, were actually quite high on my sensitivity chart. It was suggested that I eliminate the biggest triggers for 6-8 weeks, which I did to the best of my ability. I honestly have seen literally zero improvement as a result of my diligence... So, I have another appointment to see the dermatologist on Thursday. I am going to ask him to start me back on the dreaded Accutane. Having been on it before, I know what I'm in for with side effects, but at this point they can't be any worse than the pain, both physical and emotional, that I experience on a daily basis.  
 

Where are you breaking out, exactly?Have you ever been tested for food allergies? Product sensitivities? What kinds of cleaners and facial products are you using? For ex, I'm discovering that glycerin-based cleansers make me break out horribly for some reason even though the majority of people tolerate glycerin just fine. So do products with fatty alcohols like cetyl alcohol. Your products could play a big role in the acne.

Proactiv is a big hit or miss with many people. I would advise you to try something a little less harsh and drying. I believe it's BP-based?