Are acne pills safe and effective? What kind do you prefer over the counter or in stores/online?

Which ones? It's very difficult to answer broad open ended questions. Let's assume that you're referring to prescription acne medications. By definition, all have to effective to be approved by FDA for use in States. There has to be some level of safety too. However, some are safer than others. For instance, isotretinoin is safe for female but poses significant birth defect risk. Over-the-counter non-prescrpt.