My DS has had bad acne for years and we have been seeing the Derm for years as well.
He was started on oral anitobiotics, and has had creams like tazorac and epidiuo (sp?).
Nothing was working and so after going back and forth for months we decided to do the accutane. It is a very serious drug, but thankfully my DS has had no side effects except severe dryness (but most of the acne meds have this side effect). He used lots of moisturizer and lip cream. He has to get bloodwork done each month (and girls would also have to have a pregnancy test done each month before getting another RX).
It has made a real difference for him. We have this month and one more left and I am excited to see the end result. It has cost us quite a bit, though, as our copay after ins is $180 per month just for the meds.
The other creams were expensive too...just not as much as the accutane, but the accutane has really made a difference.
Im sure that the OP's dd will have many more options before accutane. It is a last resort and the OP's dd doesnt sound that bad off. Just wanted to give our experience with the accutane.