just switch it will be well worth it even if you do break out in the beginning. I luv ortho cyclen. the only bc pill that did awesome things for my skin. I did switch from loestrin to ortho tri cyclen then ortho cyclen so yes I went from a low dose to a high and yes I did gain weight from the ortho tri and ortho cyclen but for me it was okay because im thin anyway. however, I loved being my original weight so I just watched what I ate on the ortho cyclen and I managed to be my original weight again. its well worth it to sacrifice a little more food for clear skin! it took like 4 packs before my face started to clear on the ortho-cyclen so just be patient because it'll be worth it. dnt be afraid to switch. ur not happy with ur skin on the otc lo so why bother continuing being miserable with your acne on that bc! I think it isn't effective because the estrogen is low and it keeps switching by week. when I tried OTC regular, I couldn't clear and I waited 6 or 7 months. then I switched to the monophasic version and everything finally cleared in a couple months! hope my story/advice could help; good luck!
BTW: other than the weight gain that I managed to shed and some sore breasts the first couple of months, I had no other side effects on the higher dose estrogen. everyone's body is different so dnt be afraid because you heard all these nasty side effects on the higher dose bc pills; try it and see for your self. I also recommend if you can, go with the brand name and not the generic! generics are not the same and some people only cleared after they switched from the generic to the brand name of their bc pill of choice so just saying as a heads up!