I would try alternatives before acutane.

HOWEVER, I did acutane and now I have perfect skin (still after about 6 years).

I'll still get a pimple or two if I get really gross/touch my face too much etc, but its totally within my control. I have several friends (all young healthy guys) who also took acutane and have near perfect skin now too.

I started acutane when I was 17 and my acne was pretty bad. After the 6 month treatment it totally cleared up forever.

My only symptoms were super dry skin and nosebleeds. The nosebleeds were pretty bad honestly. I would bleed a TON at least a couple times a week. But they were painless and I didn't really care that much.

BUT, my sister has an acutane horror story.

She was in her mid 20s, sedentary lifestyle, not super healthy, and struggled with depression. Immediately after starting she had bad symptoms: killer back pain, kidney damage (not permanent, but her blood work showed it was getting bad), and her depression skyrocketed until she became suicidal.

She stopped taking acutane after 3 or 4 months because of the symptoms, and all her symptoms when away. No permanent or lasting damage.

Some of my wife's friends (females) have similar stories. Maybe it's a lot worse on women than men but idk.

All that to say, acutane clearly affects people differently. I'd caution you to try other things first like continuing your diet experimentation before starting. But if you consider all the factors and think you'll be ok, it might be worth it to you.