bonnyb1 - I am 34. I've had acne on and off since my teens. Like I say, it only ever eased off in pregnancy. I never had a lot of spots, but the ones I did have were large and really painful, and quite widespread.
I've had loads of anti-biotics and lotions over the years and nothing worked for any length of time.
With roaccutane, you have to use two forms of contraception, as it is really dangerous to conceive while on it. I stayed on the pill(dianette) and used condoms.
Dianette worked for my acne for a while, but it's not recommended for long term use.
The roaccutane started to work after the first month, and my skin is still improving now. Scars are fading and I feel so much better
Side effects were really achy joints - espescially my hips. You get unbelievably dry lips while on it. Other parts get very dry too
I always wore make-up. I was in that vicious cirle of wearing make-up to cover spots, but I don't suppose the make-up helped my skin breathe etc. Now I wear a tinted moisturiser to work, and no foundation or anything at home. I was very much a "make-up on to answer the door" person.
I hope that answers everything. If your dermatologist recommends it, I would give it some serious thought. For me it has worked and my dermatologist says when it works this well, there is a 98% chance the acne will stay away for good.
HTH