Back and chest acne - Accutane hasn’t worked for a second time, can you help?

I have bad persistent back and chest acne - painful big itchy yellow heads mainly and I had amazing results post accutane both times but after a year it all came back & same timeline for my second round. I’m feeling so lost Im not sure what else I can do as I don’t really want to go on accutane a third time as I fear more dangerous long term affects as a result putting my body through it again. Any help would be amazing I’ve already tried everything but I’m willing to try again or new things.