I took accutane. I developed acne in fourth grade, and it got worse as the years went on. It wasn't just on my face, it was on my back, my chest, my upper arms, even on my ears! I started seeing a dematologist in eighth grade.
Years of pretty much everything else didn't work, I tried retin-a, tetracycline(allergic!), some other cream that I can't recall the name of...finally, my freshman year in college I went on accutane. I had to have blood drawn each month to prove I was not pregnant before they'd fill the script (though the only way I could have been pregnant was via immaculate conception, lol).
It took two six-month courses of accutane to clear up my acne. I had a flare up again about a year later which subsided with a three-month course.
I did not experience the joint pain or anxiety that others have mentioned. I did have terribly chapped lips--they would almost cave in completely if I forgot my blistex, extreme sensitivity to the sun, both in my skin and my eyes. The biggest thing that happened is my hair really thinned out. A lot of it came back but I still have thin hair.
For me, it was worth it. Acne impacts people socially in ways that people that have never suffered from it cannot realize. Once my acne cleared up I was much more social, made more firiends, and was more outgoing and comfortable with myself.
Good luck with your decision.