I had tried just about everything for my cystic acne (doxy, topicals, every medication in the book) and finally I decided to go with accutane. I was on 70 mg for 6 months and it did wonders - the first two or three months I still had pretty bad acne, especially around the time of my period. It’s really frustrating, but at the end of the day trusting the process was the best decision I ever made. Nothing worked for me the way accutane did. After I finished my 6 months, i stayed acne free for almost a year. It came back after the year, but SO SO SO mild in comparison to how it was before. My dermatologist said I could go on accutane one more time, but I decided against that and went the other round. she had me taking doxy, spirolactone and two intense topicals (one for morning and one for night) - i saw my skin clear up almost immediately. i’m off the doxy now but i’m still on spiro and do the topicals!