A 28-year-old woman presents with worsening facial acne over the past year. This is mainly located on her jawline and chin and tends to become worse in the week before her menstrual period. She has used over-the-counter benzoyl peroxide and salicylic acid washes with no significant improvement. Three months ago, her gynecologist started her on a combined oral contraceptive pill containing levonorgestrel and ethinyl estradiol. She feels her acne has become worse since then. She smokes around five cigarettes per week and consumes dairy products daily. There are no recent changes to her diet, cosmetics, or stress levels. Her medical history is unremarkable.