I ended up on accutane after like 3 years of recurring acne. Tried on treatment, worked a bit, then it came back and that treatment was no longer useful. Went to another, and so on and so on, then accutane finally came up. Had a friend who used it and swore by it, so I figured I'd give it a shot. It is very serious, and you do need to sign a waiver before taking it, one of the apparent side effects is that it may cause you to become depressed and possibly commit suicide...
I'm done my 5 month regime, and it definitely did a lot of good. I'm on my fourth month after finishing it, and my face is a lot clearer. This is the longest time I haven't really had an acne problem as well, hopefully it stays this way (knock on wood). Things to keep in mind, you should probably stop with the alcohol, accutane is supposed to have serious effects on your liver. For some reason you're supposed to keep vitamin A to a minimum, so if you're taking a multi-vitamin, find something that doesn't have Vitamin A (I used "stress tabs" which is like a multivitamin for older people =/). Also, I suggest trying to eat a bit better and exercising, the drug may affect your cholesterol levels, so stay healthy. I started taking it in winter, so my face and lips got extra dry, keep moisturizer and lip balm on deck. This may also happen to your nose, so ask your pharmacist for some sort of nasal moisturizer. Good luck, hope it works out!