A new review of 226 clinical studies, published last week in the Journal of the American Academy of Dermatology, took that question head-on with 32 randomized trials comparing the zit-zapping powers of oral contraceptives and antibiotic treatment options.
The results showed that during the first three months of treatment, antibiotics resulted in a larger reduction of acne lesions (48%, vs. 37% for birth control). However, by six months, the oral contraceptives were slightly more effective than antibiotics at treating acne: Those on birth control experienced a 55% reduction in symptoms, while antibiotics were associated with a 53% decrease.
The hormones progestin and estrogen are most likely to thank for this effect; they slow down the production of sebum, a naturally occurring oil that can cause acne.
Which BCs have the most acne-fighting potential? According to the NIH, there's not much of a difference among them — although Everyday Health recommends Yaz (despite its widely reported side effects) and Ortho Tri-Cyclen.
Of course, everyone's skin is different, not to mention their hormonal makeup, and this study only looked at oral antibiotics, not topical treatments. Still, the research confirms what many women already know: Those pills could get your skin under control, too.