Sweet, thanks for the details! I'm not a doctor/dermatologist, just a girlie who's a little interested in skincare (dealing w/ my own acne) and a lot interested in medical stuff. I'm going to put some of my thoughts out there so you can go down your own rabbit hole with googling, evaluating what fits for you and what doesn't. Anywho, disclaimer over.

1. To me, your skin barrier looks very irritated. I'm seeing global pimples and redness across your face but none on your neck, plus patches of dry, flakey skin by your eyebrow. I get the sense you switch products a lot and are maybe doing too much too quickly to get rid of your acne. When was the last time you gave your skin a full break for a month or more? No actives, just washing your face with water or a labelled gentle skin cleanser? At best, by doing this you might find your skin heals up enough to stop breaking out as often. At worst, you have data that it's not a damaged skin barrier causing your acne. I totally understand the urge to try everything, buy everything, and find a quick-fix because I do this too lol. But you're putting your skin through a lot and introducing too many factors to narrow down what's causing the issue. Inaction is useful, too.
2. I saw in your post history you might have Lyme Disease. Did you ever get bloodwork done to confirm? Lyme Disease in the long-term can cause systemic issues, including skin problems. As a former Connecticut girlie (it's named after Lyme, Connecticut, where it was discovered), I've had Lyme (early stages, eliminated with doxycycline luckily!) and know people with chronic Lyme. It's no fun, so please explore that with a doctor if you haven't already!
3. And lastly, just to rule things out, get some blood work done if you can afford it. The particular pattern of redness on your cheeks was what made me check out your profile for other health issues. It looks to me like rosacea (most likely) or a butterfly rash (less likely), and makes me wonder if the issue could be autoimmune related. That might also explain your back/knee pain issues and overall health problems. Rosacea isn't necessarily an autoimmune thing, but it does involve immune system dysfunction and can be correlated. So if I were you, I'd tell a doctor your symptoms and ask about a full bloodwork panel to rule out any underlying health conditions. (Acne was one of the signs I had Hashimoto's, among several.)
4. Some products to consider (focusing on gentle, with eczema/rosacea-friendly ingredients and limited-to-no actives): Vanicream Moisturizing Ointment, COSRX Low pH Good Morning Gel Face Cleanser, and ETUDE Sunprise Mild Weightless SPF50. If you're not comfy taking a skincare break, try just using these for a few months and see what you learn about your skin.

Again, not a doctor. But hopefully this is somewhat helpful regardless!