Which oral contraceptives have the lowest risk for blood clots and treat acne? i'm concerned about clot risks while starting out on ocella (drospirenone and ethinyl estradiol).

Rock and hard place: I am afraid you are between a rock and a hard place. The birth control pills with a progestin in them that has antiandrogenic effects, e.g., drospirenone (Ocella) or cyproterone acetate (not available in the US) have been implicated in blood clot incidence. You may want to pick a different birth control pill and have a dermatologist take care of the acne.

Sprintec: Norgestimate 180/215/250 µg plus 35-µg ethinyl estradiol in an OCP such as Sprintec has the lowest risk of DVT among those OCPs approved for treatment of acne.