I had acne from the age of 8, and then it just got worse and worse.
I didn't have the worst acne in my school (teenage years), but enough cystic acne to cause a bit of scarring, which I still have. Not severe, but enough to be noticeable.
So at age 19, after trying loads of antibiotics and every prescription skin cream possible, I went on roaccutane (or 'accutane' as we call it in the US).
As for side effects. I had incredibly dry skin for the course of the treatment. And I had depression, which included suicidal thoughts. But I was always prone to depression. The accutane probably made it worse, though. Now I'm 36, have never again had acne since (except for the odd spot). I don't think I've had lasting damage, but how can you ever know for sure? I do continue to have on-off severe depression (bipolar type 2) but I think I was born that way, and doubt it was an effect of the accutane I took at age 19.
I'm happy I took accutane, on balance. Nothing else wwas working. My face would be badly scarred by now if I'd not taken it. And our world so looks-obsessed, that if my skin hadn't cleared up when it did, I suspect my life might have turned out markedly differently.