I see this question all the time, and the answers are always split and straightforward. Those who took it with standard side effects and toughed out the dryness, chapped lips, and so forth find it to be life-changing for the better and completely worth it. They often look down on the controversy that surrounds the drug due to their experience and joy of clear skin that changed their emotional state as well. Those who took it with major negative side effects or long-term problems advise against it, of course, and would rather live with their acne again than go through whatever issues they now have or had with their liver, bowels, or mental problems.
I can tell you, oddly enough, I fit in the middle and tend to agree with what Like Moonlight said. You have to weigh the risk for yourself. I got health insurance just for Accutane after many years of issues in a similar boat as you. I have acne right now that seems moderate, but when it does poke through it leaves very deep red marks that in my case will last sometimes up to 5+ years. I took the drug recently, truthfully unworried about anything bad happening with side effects outside of dryness because I knew that the statistics were very low for those cases and that millions have benefited greatly from the drug.
5 weeks in my course I developed a scary anxiety that led to many physical issues with breathing, swallowing and heart rate. I have been off the drug for 1 week (Dermatologist and Doctor ordered me to stop) and still am dealing with some tightness in chest and breathing issues off and on that are really frustrating and saddening for me. This hopefully will go away, as the drug has not had time to leave my system completely yet.
Despite the nightmare I went through in my last week of taking the drug, I have to say I am happy that I tried it. I still have the issue of acne, but it is freeing to have checked that drug off the list for good. My opinion of course may change if I find that the some of the issues I am still having become more permanent, but I'm not there yet so I can't say. My brother took the drug and deals with some type of skin rash ever since (15+ years), but he still feels the trade-off was worth it. What happened to me is indeed rare, and it feels unbelievable after everything I went through with other prescriptions and to finally be on this drug that I would just so happen to fit into that small group of people with more serious side effects, but it shows that it can and will happen to anyone.
If you haven't exhausted other options, I would try them first, otherwise, you can see how you respond to Accutane and hope for the best! I will tell you personally that after many years the drug that worked wonders for me was Bactrim DS, but unfortunately I grew resistant to the drug after 3 years.