Hi - sorry I am a little late joining the thread. Hopefuly you're still around...
I took 5 months of accutane last year for cystic acne on face and back, after 15 years of unsuccesfully trying every antibiotic (gave me monthly thrush) and topical treatment (bleached all my clothes) available, and trying Dianette (less oily, fewer spots, but not great) and Yasmin (sent me completely loopy, with vestibular migraine and horrible anxiety, then hair loss when I came off it).
It worked wonderfully at the time, no excess oil, no cysts and almost no spots at all for months. After 4 months, there has been a slow creep back again and within the last couple of months my back is a mess again and I am really oily in every place can produce oil.
I am waiting for a referral to go back to the dermatologist to ask for a second round of treatment - which the GP says I shouldn't have and will probably be refused. If they do refuse, then that's fine but I would rather hear that from the specialist than from a GP that doesn't know me or my history.
My acne is definitely hormonal, but is there constantly. I am 40 and have had enough of hiding my skin. I would say that at 20 your skin will change a lot in the coming years and your body's reaction to hormones (natural or synthetic) will also change. For me, my acne appeared in my early twenties and just hasn't gone away (save for when I was pregnant).
I am hoping round 2 of accutane works, despite the side effects. For me, they were joint pain (hips), a couple of eye infections and extremely dry skin.
Good luck OP!