So difficult child went to new dermatologist and she said we had to do something systemic. We have tried so much otherwise- from natural to antibiotics, birth control and so on. She even explained that difficult children IBS could be part of the acne. It has gotten so bad-big cysts on back and face is a constant battle. She recommended a 6 month course of accutane. She said she would go on it and even put her own kids on it. It scares me. difficult child had to sign a pledge-has to use 2 forms of birth control and promised to stay on her birth control and to use abstonance. She has a history of sexually acting out, so I am scared. Pretty sure she hasn't acted out in about 4 months. This drug causes severe birth defects before you even know your pregnant. She will have pregnancy tests every 30 days and blood tests for liver function. It has also in some cases caused psychosis and severe depression. difficult child has a history of depression. I told the dermatologist this. She told me that she though difficult child would do well and that it would help her self-esteem and in the end depression. She told me to read it all and scare myself. There is a 30 day waiting period before she can start. What do any of you know? Any experiences? difficult child Is determined.