Accutane definitely works, but I would see a dermatologist and shoot for a prescription antioibiotic with less severe side effects initially. Tetracyline and doxycycline can be very effective, especially when coupled with a topical treatment such as Retin-A or the more recently prescribed Differin Gel. Another prescription drug which is not an antibiotic and seems to consistently yield excellent results is Spironolactone. This is also a diuretic, as well as an anti-androgen. As I'm sure you know, Accutane is extremely hard on the liver, so if your dermatologist does recommend it, be prepared to undergo at least monthly blood tests to monitor your enzyme levels. Good luck!