M.R.
Just checking - does your regular face-washing routine include a gentle/mild cleanser followed by a toner and then oil-free lotion? A lot of people who have break-outs think they shouldn't use moisturizers or lotions because it will clog the pores. However, if you're not using an oil-free moisturizer then the washing of the skin makes it dry and the skin will produce more oil to compensate for the dryness, further exacerbating the problem. I'm sure you already know all this but I thought I'd include it just in case.
Are you opposed to using oral contraception to manage these issues? Do a little bit of research on anti-androgenic birth control pills. The symptoms you describe could be a result of an overproduction of testosterone, and some birth control pills have the added benefit of lowering those levels in your body. It is definitely something you may wish to discuss with your gynecologist. Good luck!