When I first went to the dermatologist, after my examination, he suggested that I go on Accutane.. But because of insurance stuff ''they had to try an alternative first.'' The first medicine they gave me was an antibiotic (it was a huge pill) & a topical cream to go with it. (It is troublesome putting cream all over ur face & back every day.) And after being on that for a month or so, I got HORRIBLE cramps, like you're sweating, can not stand, feel like you're going to puke & crap.. (lol) & one day I swallowed one of the pills without water & the next day, I had acid reflux. After three days of pain, I went to the doctor, found out it had gave me gastritis, & got meds for that. After that, I finally went on accutane. And what do u know, after 5 years of severe acne, I am generally more clear skinned than everyone else. I am still on accutane. There r some down sides, but IF u need that, ur doctor will explain them..