I think as a female at your age you really should be eating more food. Your weight its probably the lowest it should ever be, any lower and you might not be able to maintain fertility and proper hormonal function, that might be one reason you are having acne. In females, too low a weight can produce an imbalance in testosterone and cause hormonal acne.
If I were you I would take a look at Inger's journal and see what and how she eats food and in what quantity. She probably eats what you eat all day in one meal, and is still very lean, beautiful, smooth skin and fertile.
I would suggest more fish as well, definitely branch out into different types, oysters are excellent. Even if you have to lightly cook the fish to make them more palatable its a great idea.
Do you have access to grass fed raw dairy and, if so, have you ever tried it out? I find that small amounts of fermented/aged raw dairy, such as full fat yogurt or raw cheese, makes my skin exceptionally smooth and gives it a good amounts of moisture(not greasy!:)!) I think it is also a great food for females but should be eaten by itself, not mixed with anything, and in small quantities.
Are there any wild berries you can pick your self, for example rose hips or hawthorn are later fall/winter berries. Rose hips are pretty inexpensive to buy dried and in bulk.
I am in the PNW and eat seaweed harvested from our coasts. True, the ocean is polluted, but so is the air and all of our food has some inherent pollution because we live in a polluted world. I don't think that means you shouldn't breath or be afraid to eat, you just have to limit exposure and heal your body so all that it is dealing with are those pollutants. Our properly functioning organs are fully capable of this. You can try some Klamath seaweeds/spirulinas, from lake Klamath down here in Southern Oregon, but it still gets particulates from chemtrails and jets and, industries and cars. I try not to be too worried about this. I only mention it because grapefruit and pith and tomatoes are high potassium, and because you are eating so low carb you are probably craving potassium. Perhaps try munching on some dandelion greens, there are so many wild edibles out in Seattle and surrounding that might be good sources of nutrition for you.
Have you, or would you consider to dry age your meats? Like make little meat balls and patties and then age them in the open air so they dry out a bit? sometimes I find this makes meat much more paletable, plus it might help to get some good bacteria going in your body to help your digestion and complexion.