My last option was always accutane. I tried topicals and different birth controls. Nothing worked. My severe and cystic acne remained and I was an emotional mess. I couldn't leave the house without makeup, and sometimes I couldn't leave the house at all. I finally decided to go on Accutane knowing the side effects. I was prescribed Zenatane and started seeing the results 3 months in. Everything cleared up. At the end of my 6th month cycle I was acne free. It saved my life. The worst side effects I had were severely dry skin(chapped lips, bloodshot eyes, and nosebleeds) and fatigue(lack of energy on a daily basis). The side effects were worth the end result. I still have some scars from my deep cysts but they are slowly going away and I'm about to start microdermabrasion. My insurance covered my Accutane and birth control, but didn't cover a lot of monthly blood tests which was a bummer. I highly recommend anyone who has tried most things and failed to try Accutane. My before and after pictures have no editing or filters- I'm so proud of my new skin!