Thanks for the reply. I have both extremely oil skin and persistent acne. I took one full course of accutane in the past and both the oil and acne came back after 2 years. I'm on my second course now, but I think after this course things will start going South again. I'm considering low dose accutane as a long term solution, but I have my reservations about it... I also seem to get fatigue and joint pain from it, but I'm on 40mg a day. I love having no oil, though. It's crazy how much the lack of oil improves my quality of life.
If you have severe acne then I don't know if a low dose will be enough, but most people who do it see a reduction in oil that is just as drastic as taking a large dose. It was effective enough for me that I'm planning on doing it again.
I have to say though that the idea of having to take isotretinoin for the rest of my life is really depressing, but I just don't know what else to do. I've considered looking into a diode laser treatment since in the long run it's probably cheaper than paying for Accutane forever.