^Have you tried tazorac yet? It's the strongest retinoid available and some people consider it the "liquid accutane" because it's effective and has some similar side effects such as severe dryness, etc. My derm prescribed this to me a few months ago (in conjunction with benzaclin) and my skin looks amazing right now. I didn't have to deal with any weird side effects (except maybe a little purging), though, so I feel lucky. This seems to be my magic bullet!
Someone also told me that spironolactone cleared them up beautifully and insisted I go on that, too. What it basically does is block androgen (male hormones) receptors so that your hormones can be more balanced, so ideally, this would solve a lot of acne problems for women. (But I didn't go on this because my derm told me it has a lot of side effects as well and put me on taz instead.)
But I suppose if you've discussed and went through all the options with your derm, and you really have no other choice, go on the accutane... although personally I wouldn't do it (why potentially damage a perfectly good liver for clear skin?). Then again it probably won't be that bad, you're likely to just get really dry, sensitive skin and lips for a few months.
