It depends really...that's why there are several types of acne. HIgh histamines can definitely cause acne, but it looks different than hormonal acne. It closely resembles welts. I went on an extreme low-histamine diet for a month and my acne disappeared. IgE caused reactions are different than IgG ones. So I think there are several ways to treat it, even if it's hormonal, you don't necessarily have to use hormonal treatments depending on its severity.
Also, I don't think all acne is due to elevated DHT. I had signs of elevated androgens but my face was clear when I was using herbs to regulate my estrogens and progesterone. I don't think the mechanisms behind acne are fully understood, even by so called medical professionals.
I would be interested in finding out more ways to treat male hormonal acne because men have fewer options than women when it comes to that.