Hi, Weight gain and hair loss are some of the known side effects of Alesse. However, the extent of these side effects vary from person to person. Also, in some cases, due to failure to retain the water, the pill acts as a diuretic and due to fluid loss, the women may actually look slimmer. About acne, it acts to improve the acne symptoms than to make it worse. In fact, birth control pills are used to treat the acne of mild to severe intensity. Though in some cases the the symptoms of acne may be temporarily worse due to progesterone having an effect like pseudo-testosterone, but definitely, it will improve the symptoms of acne afterwards. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Satnarain Bansal, General & Family Physician