I notice that mine gets worse when I eat a high GI diet (starchy stuff, sugars, etc). I heard that it triggered insulin production, which makes you produce more oil/sebum, which gets clogged, etc. You are eating very healthily, but some very healthy things have a high GI. Check it out if you're open to it.
Accutane always seemed kind of scary to me, it helps people with bad acne but it also stresses out your liver. I have a friend with acne who's been going to a derm for years, and all she's developed is extra sensitive skin and desperation, because something will work for a few months and then it won't.
Anyways, try the GI thing, try some more tweaking with your diet. What works for me might not work for you, but try and find your triggers and go from there.
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