I did take a second course of accutane. The first worked fairly well, but the second took me the rest of the way.

Op here...many thanks for those thoughts. I ended up going with accutane and will start in 30 days. I figure I don't want to take the antibiotics just to SEE if they work when I know the accutane worked for me those years back. Crossing my fingers, so incredibly tired of having acne!

Accutane in high school helped take the edge off but wasn't great. Tried again in college a few years later and it worked then. So whether it was the second round or just a change of body chemistry, it worked.

Have you tried Retin-A? I was in the same situation as you are. I had a round of Accutane in my mid 20s and then had a baby at 30. My hormones lost their minds after that and I considered another round of Accutane. My derm had tried antibiotics which worked okay but didn't do the trick. Then, she put me on Retin-A generic even though I told her no topical had ever worked for me. 4 months later, my skin is as clear as it has ever been. I only use it every 3rd night b/c it is very drying otherwise. My skin was horrible the first 2 months and then it cleared up and has stayed clear. I am also on a BCP too.

I am meeting with my derm next week to discuss options. Acne has returned after a 3 month treatment 5 years ago. Nothing topical works, and it's awful. I feel 13 again, and not in a good way. Accutane was so successful for me, totally clear skin, but then I got pregnant and I think the hormones went into overdrive again. Has anyone been successful with a second round, so far after the first?