Would you recommend Accutane, or other options? (Photo)

I'm wondering about accutane or other options. I'm currently on 150 mg of spironolactone. I've done aczone, clindamyacin, Retin-A and differin gel (at different times). Spiro cleared me for a few months, but then it came back worse than it has ever been. My acne covers the "beard" area that exists in hormonal acne. It is painful and crippling to my self esteem. It is also getting worse by the day.