I take orth tri cyclen lo for acne. When I want to go off the pill, will my acne return worse because of hormonal shifts?

Possible. It may happen. You could try other treatments like retinoic acid, oral doxycycline, azelex (azelaic acid) cream, or clindamycin gel if you want to give yourself a break from the birth control pills. Consulting a dermatologist is best.