[Acne] At what point should someone consider Accutane?

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Hi everyone! Reposting with the proper tags. I'm in a slightly frustrating situation, ATM. Background info:I've had cystic acne since I was about 12 (I'm currently 20F). It stopped for a short time (15-18) but is back again.At any given time I have about 6-8 pimples, 2-3 of which are usually cystic.I've been treating it with both OTC products (AHA, BHA, Witch Hazel, etc.), birth control, antibiotics and EpiDuo. I don't usually a ton of products at once, and I try products out for about 4-6 months before giving up on them.I have dry skin, its hereditary and I've had it even before I started breaking out. Since I've started using EpiDuo, my skin has gotten more flaky.I scar very easily, so every pimple I get leaves a dark spot even though I never pop them.Routine:AMDickinson's Witch Hazel Cleanser almost every daySt. Ives Salicylic Acid Scrub or Nip Fab Glycolic Fix Scrub 1x a week if my skin is really breaking outGarnier Even Brighter Dark Spot Corrector serumBio Oil or Boscia Sake Balm as a moisturizerPMDickinson Witch Hazel CleanserEpiDuoBio Oil or Sake BalmGlamGlow Super Mud as a spot treatment for cystsThat being said, nothing has helped stop my acne. The most recent dermatologist I went to said I should consider Accutane. I didn't really trust his judgement because he isn't a Board Certified Derm (he's Internal Medicine certified, but has a dermatology practice) and was really judgmental. I plan on going to another derm in a few weeks, and I will follow whatever they recommend, but I'm so nervous to go on Accutane. I'm worried it will be a disaster with my dry skin or that it won't work.Pic 1 Pic 2 My cheeks are the only place I have any acne right now, the rest of my skin is clear. this is typically what my skin looks like, right now I have 1-2 under the skin cysts that can't really be seen.Edit-I forgot to mention that I've cut out dairy, red meat, excess sugar and fats from my diet, take multivitamins, drink plenty of water and use a new pillow cover every night. Nothing lifestyle-wise has helped :(
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Submitted by gotta_mila