Almost 1 month ago today I started taking birth control pills for the first time. It was sort of a two-pronged solution- I wanted pregnancy protection and hopefully relief from some of the issues i've had since puberty (painful, irregular periods, chronic ovarian cysts, and of course acne). The doctor prescribed me Alesse when I asked for something to help with my skin- she was just a clinic doctor, not a derm/gyno and in Canada where I live Alesse is actually FDA approved for treating acne.

I went through a 2 week initial breakout period as expected- cysts in places I usually don't get any acne at all, my jawline and cheeks went generally crazy- my acne was almost doubled. But flash forward 1 month (I have 1 sugar pill left on my first pack) and I'm almost clear. I went from 6-7 inflamed lesions and perhaps 10 whiteheads at a time to a few whiteheads and between 0-1 inflamed pustules at a time. My skin feels smoother and looks so much more even in texture. It's less oily as well (although i've always been combination leaning towards dry, so thats not necessarily something I needed).

It sounds great, but my worry is that it's temporary- I know from researching Alesse after the fact that its supposed to be very androgenic and pretty awful for acne, and that the pill usually takes longer to work than a month. Can anyone give me a little insight as to how these things work? Is this period of clear skin the calm before the storm or is the pill doing good things for my hormones?

I'm 21 and fairly small (115 lbs before the pill, about 120 now) if that helps at all.

Oh, I forgot to mention that I have a 3 month supply of Alesse. I obviously plan to stick it out and see what happens, but it would be nice to have some answers in the meantime. I'm not really open to Yaz since I'm a smoker and the blood clot risk scares me, and anything high dose is unappealing as well since I managed to gain a few pounds and go up a cup size on a low dose pill and i'm a little worried about what a higher dose pill would do to me.

Is there lower dose less androgenic pills that I could try if Alesse goes south?