"i do believe, as all of you have stated, that accutane is by far, the best form of treatment for cystic acne. i am 43 years old. i didn&#039;t have acne as a teenager, but ended up getting it in my early thirties. i have been on and off accutane for the past 13 years. it does work, however, in my unfortunate circumstance, it always comes back. my doctor tells me that there are a select group of women who don&#039;t get acne until they are in their thirties and forties. for many of the adults, 1,2,3, or even 4 courses of accutane don&#039;t work without the acne coming back at some point. for me, i have to take a consistent low dose to keep the acne at bay."