Switching from Lo Seasonique to Seasonique: Acne and Breakthrough Bleeding

Question
Dr. Solberg,
After a year of loSeasonique, I still couldn't get through the 84 days of active pills without breakthrough bleeding, so my Ob-Gyn switched me to regular Seasonique.  I started regular Seasonique 2 weeks ago and have noticed some acne.  Could this be the result of the new dose of hormones or just coincidence? I never broke out on loSeasonique.

I went through 4 different brands of pills before finding one that controlled my menstrual issues without affecting my moods.  I felt lucky that the combination of hormones was the same one used in the extended cycle regimes.  I really like the idea of 3 periods a year, but don't think acne is a trade off I'm willing to make.

Answer
Hello Carly,
Although the acne could be the result of changing from LoSeasonique to Seasonique, I suspect that it's coincidence.  The ingredients are the same, and the Seasonique has half again as much of the estrogen and the progestin in each pill.  Usually estrogen improves acne, and the progestin can make it worse.  The pill in general tends to improve acne, but not always (depending on the pill), and not for every woman.  Stress and other things can make acne worse.  I would give it another month or so to see what happens.  If the acne continues, you may want to try a different pill.