Acne and oily skin are mostly caused by DHT. There are some lifestyle factors like diet (milk product or chocolate consumption), lifestyle (sweating), and genetics (history of acne in puberty) that makes someone more prone to the effect of DHT on sebum production.
I've had great success using Nizoral (1% ketoconazole) shampoo to control the acne and oily skin I get on my back with TRT.
I rub the lather all over my back and any other problem areas once per day in the shower, leave it on for 5 minutes, then rinse it off. I notice a huge improvement when I use it consistently once per day. I also use it on my scalp to hold off any baldness, but thankfully that hasn't been a problem for me yet.
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