I was on the pill or patch since I was 22 (am 37 now). I went off the patch about a year ago because of all of the health risks that I kept hearing about. It was about 3 months after I went off the pill that I developed terrible acne. I broke out like crazy, especially around my cheeks and my chin (large patches of acne, not just one or two pimples).
I honestly don't remember having acne when I was a teenager - just a pimple here or there. I do recall several red dots on my face at the same time, but never like it was after I went off the pill last year....
This past fall I went to see a dermatologist. She prescribed a benzoyl peroxide face wash called "Oscion Cleanser (3%)", as well as a cream called "Tretinoin Cream, USP (0.05%)". She also prescribed anti-biotics and a pill that lowers blood pressure (apparently it's been found to help acne), but I didn't feel comfortable taking either of those, so I never filled those prescriptions. I only used the face wash and cream. They have helped tremendously! My face has never really gotten completely clear, but the large "blister" type pimples have gone away and now I just have a few dots that are much more smooth and only a little red (and much easier to cover with makeup). I still get the occasional breakout, especially around my period, but otherwise it's not been too bad. I'm happy with the way my face looks on good days
One thing I also added myself and I think this helps a lot too is a facial scrub called "Soft Glow Gentle Face Polisher" made by American Beauty (I buy it at Kohls). When I use that almost every day (even though it says to use it twice a week), along with the prescribed cream and face wash, that's when my skin seems to be at it's best.
It really is a lot of trial and error. You can try different acne products, moisturizers, makeup, etc. to see which ones work the best for you. Some will be better than others and some work well for some, but not others, so you may just have to try it and see what's the best for you.
I know how frustrating it is, but hang in there and give your body some time to level out the hormones and then see which skin care products work the best for you. Good luck!