Any advice appreciated! Bit long sorry..

25, female

Acne started early teens - few on back, mostly cysts on face

Treatment - creams, tablets, pill etc since age of 16

It is very much related to my period, i break out around that time with cysts that sit under my skin for weeks and they eventually cause scarring. I have been on dianette since the age of 16 with a break now and again to see how my skin is without it - breaks out after a month of not taking it.

I have been on a new tablet - Tetralysal Lymecycline 300mg capsules for around 4/5 months now. At around 3 months there was no improvement at all and considering this was stronger than all the other tablets I had been on I went back to my doctor to discuss who agreed I should go see the dermatologist and possibly be put on accutane.

Whilst waiting for my appointment to come through for the past 5 weeks my skin (compared to before) has been perfect. I have the odd little pimple and I do have whiteheads/blackheads but no actual large or visible spots. If it stays like this I would be happy but I can't guarantee that it will it may just be a one off - we all know sometimes that happens.

My problem is..

I've just returned from the dermatologist who agreed I should be placed on roaccutane for 4 months. He said I do have deep acne, this should really help with that but the superficial acne may be likely to return eventually (I'm assuming he means the odd pimple etc). Any other time I would not question the decision to try this treatment however, as mentioned my skin is the best it's been in a long time and the thought of making it worse again before it gets better really puts me off.

I am due to start a new job around 3 weeks after I would have started treatment and I just know I will break out severely and it will destroy all my confidence. Also with a new job I'm not sure how I will get time off to attend these appointments for blood tests etc and also I'm worried about the severity of the side effects, I don't want to be really ill at work or even have to be off sick for any reason.

I know everyone reacts differently but knowing how my skin has been over the years I don't expect to get off lightly with the side effects..

I burst in to tears when I left the dermatologist I was so frustrated I could have had this treatment years ago, the timing is just so bad and like I said if it stayed this way even just for a year I'd be quite happy continuing with these tablets for now. Do you think if i refused the treatment just now I wouldn't be offered it later on?

I have attached photos of my face when it last flared up in July and how it looks just now.

I'm due to go back in 10 days for further tests/pick up tablets so I am supposed to stop my current ones just now..