hi, i just realized that i've had acne for 12 years now, so i definitely know what you're going through! the only topical prescription drug that worked for me was Benzamycin...it took 10 months for my skin to clear up, but after that it worked great. but since i no longer have insurance, i compromised with my prescription costs by chosing birth control pills over the Benz. i've been taking ortho tri-cyclen for about 2.5 years. it really helped to clear up my chest and back acne, but not my face! Grrrr! i have an apointment w/my doc soon, and i have been thinking of changing to Yasmin after reading a lot of posts on this forum. you might want to try these types of pills as they have direct affects on your hormones, and they also help to regulate crazy periods! as for topical, i'm using a system called Klear Action that is a rip off of ProActiv. you can get it at walgreens or sav*on for half the price. i've only been using it for about 3 weeks, though, so i can't testify how great it is yet. but so far it doesn't dry out my skin too badly. i just got a few new breakouts, though. as for accutance, i hear it has a lot of bad side effects, but a lot of people find it is the ultimate cure. you might want to try it as a last resort, though? good luck, let us know your progress!