well i just finished a 6 month cycle from a derm. You must have a bad derm, cuz most will put you on it. You tell them that you have adult acne, everything hasn't worked, acids, anti-biotic creams, pills, nothing.. You want accutane! You'll get it! My doc asked, the very first question out of his mouth was " Hi, nice to me you..I'm so..and so..Do you know what you want? " I was flabberghasted to say the least! I wish all docs would say that.hehe. I tried the cream - acid /antibiotic for 12 weeks, even though he originally wanted me to do accutane. After 12 weeks, i realized it was a waste of time. So I ran 60 mgs of accutane for the first 2 months until I developed a small rash on my forearms. This is what derms look for, it means that it is actually changing the oil pumps, chemistry, skin pores. So I said, let's go higher, and he said, 'hell ya!" So I went to 80 mgs a month and stayed there for 6 months. If there's any liver issues, it will be in the first 3 months, after 3 months, i didn't have to do it anymore. (blood tests that is). I would seriously, look around for another dermatologist. Most derms will give you this, although, it's more of a pain to get the meds now with enhanced gov. restrictions and the i-pledge program, but even now, after 3 months of being off, i hardly ever break out and i even tested it by running 4 weeks of test, which I ALWAYS break out on.. NOTHING....but maybe a few dots here and there..i'ts FREAKIN awesome to be finally rid of acne..I'm 34 and have had it since a kid..If you do it the ug way, it gets real expensive. You absolutely 100% need to run it atleast 60mgs to correct the issue for 6 months. If you have ins. find a derm that will prescribe it. Just call around and say that you are an adult and that you have adult acne. But, if you look like you JUICE, more than likely, this is why you might be getting turned down for the accutane..i don't really look like i juice a lot, so i can get away with it..I just look cut..nothing huge..But, like I said, call around, you'll find someone..it's worth it, trust me bro..