I've taken roaccutane...1 course was enough for my skin, and it had amazing results.I was monitored closely by my dermatologist, and besides the dry skin (which, with lukewarm showers, lots of 8 hour cream for my lips, and generally following my Dr.'s advice, I could minimise) I had no other side affects.I also tired to stay out of the sun, as your skin can be more sensitive to the sun's effects.
I've had no problems with my skin since then, and I had cystic acne (localised to my t-zone) that was quite painful, at times.I would reccomend it, if like myself, you've tried every other treatment available, and it's not clearing up.It's great being acne free & not having that worry about your skin all the time! Good luck with it!