The Accuatane effect is overblown simply because the results of a lipid profile while on it is useless. Sure it mess up the test. Sure the readings are of someone who's worked at McDonalds their whole life. But in the long range prediction of CAD, which is the purpose of the test, this one episode is insignificant.
The doctor will not, at least should not, pull you off Accutane because of a lipid profile. If your liver tests are poor over a 2 month period they may pull you off but not for lipid panel results. No matter how ridiculous the lipid profile looks, like mine has at times, it is not permanent. You come off, keep a clean diet, maybe add policosanol, and you're Lance Armstrong within months.
No one I know uses Accutane who doesn't have cystic acne. I had to wash my sheets every night because they were bloodied by the acne on my back when I slept. THAT's when I turned to Accutane.