Coming off Valette — terrified of acne coming back. Help choosing between Slinda + estrogen gel or going med-free (on 100mg Spiro)

Hi all, I’m planning to stop Valette (ethinylestradiol + dienogest) after 7 months, as it seems to be contributing to issues with my legs and veins. I'm getting lots of little spider veins and one of my bulging veins got a lot more painful and possibly needs to be removed now.

I’m also on 100mg of spironolactone for the past 4 months, and the combination has significantly improved my hormonal acne, hair loss, and unwanted facial hair. That said, I did experience a major breakout around the 6-week mark when I first started Valette, which was very difficult.

My doctor has suggested transitioning to Slinda (drospirenone-only pill) along with topical estrogen gel. And to stay on 100mg spironolactone. However, I’ve come across a number of mixed reviews — particularly reports of breakouts while on Slinda — and it’s made me very hesitant.

I’m genuinely afraid of my acne returning, as it had a major impact on my mental health and quality of life. I’m currently weighing two options:

1. Start Slinda + estrogen gel
2. Stop Valette and continue with spironolactone alone

Has anyone had success maintaining clear skin on either of these paths after coming off combined BC? I’d really appreciate hearing about your experiences or any advice you might have. Thank you!