"accutane is not an easy drug to take, but it does work.  i was 31 and had acne since puberty.  i had large cysts and nothing worked.  i took it for four months and it completely cleared up my skin.  i did have significant dryness of my skin and had painful joints, but it was totally worth it to me.  this was in 1990 and i have not had problem with my skin since.  i would definitely recommend it for severe cases of acne.  it changed my life."