My experience with some dermatologists is that they like to push accutane on people. They must be getting some nice kickbacks from the drug company.
One time I went to a dermatologist, and told the doctor flat out that I didn't want accutane (and believe me, I don't have bad skin). But the doctor insisted that I let the nurse give me the whole accutane sales spiel.
Women are supposed to start taking it only at certain times of the month. And you have to sign a form saying that you'll immediately get an abortion if you become pregnant while taking the drug.
On the other hand, there are some people that really need it since oral antibiotics and topical medications don't work. I've known women that had oozing postules all over their faces that I thought should have been taking it.
However, accutane doesn't even help everyone. I've read cases of people being helped by it, only to have their acne return once they stopped taking the drug.
There are also warnings that accutane could cause an increase in suicidal tendencies.
On another note, there are some pretty decent over the counter acne kits you can buy at drugstores like CVS and Duane Reade. These are generally the equivalent of Proactiv, which is advertised on infomercials.
About Proactiv, the chi chi Manhattan dermatologist to the stars, Dr. Patricia Wexler said it worked for her daughter when nothing else did.
Anyway, Duane Reade has good anti-acne kit for $10.00. It consists of a benzoyl peroxide cleanser of 2.5%, a toner containing glycolic acid, and a benzoyl peroxide acne lotion of 2.5%. There are also acne kits that contain salicylic acid as the main ingredient. Try them and see what works for you.
In the health food stores, you can also find sulfur soaps, which are great if you are sensitive to benzoyl peroxide.
Finally, if you do pick a blemish, clean the area and apply some anti-biotic ointment like Neosporin, bacitracin or Polysporin.
Hope this helps.
Lisa