I had awful acne when I first started perimenopause. Really really bad, it was so embarrassing looking at ppl and even teens had fewer spots than me. Felt desperate. It took a couple of years to really clear up, and at the time I hadn't connected it to hormones, so your ahead of me.
Menopause is like puberty in reverse in so many ways, mood swings, acne, irregular periods, anxiety and the rest.
What I did was invest in a ton of new makeup, concealer became my new best friend.
Forgot to add that after seeing GP he gave me some Zineryt which did seem to help calm it down, maybe ask your Doc for help.
TD