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HI there. I am hoping to get referred to a dermatologist soon and going on this is a possibility but would like to know first hand what to expect. so what side effects are the most common and how immediate are they? when on average should there be a change in the amount of acne?
i want to know if its worth it. i have bad acne on me back chest and a bit on my face. i dont go swimming or where tops that show too much skin as im ashamed- i would love to feel confident about myself again! i dont go out or see anyone without wearing make up otherwise i want to put a bag over my head! i know that sounds ridiculous but its true....the one bit im concerned about is depression as i do have a history-however have been good for awhile. plus my acne causes alot of it anyway. so, thoughts please 
Really the only 'guaranteed' side-effect to roaccutane is dryness - i.e. lips, face, and other exposed areas of skin like your hands and arms. How bad it gets is largely dependent on a mixture of luck and your dosage. Aside from dryness there are other fairly common side-effects such as mild muscle aches and dry eyes and nostrils (sometimes causing the occasional nose bleed if you're unlucky). The only other accepted 'common' (i.e more than 1% of patients) side-effect is the initial breakout, although sometimes this can be difficult to distinguish from a bad acne flareup that you would have experienced anyway.
Personally I regard my roaccutane experience as being totally worthwhile. The side-effects I experienced (most of the above with the exception of the dry eyes) were at worst just annoying, although the initial breakout can be fairly traumatic. Mine only lasted 2 weeks fortunately, but a few are unlucky enough to have it last in excess of 2 months. That said, unlike with topicals which act largely as just damage-limitation, you know that at some point it will get better with roaccutane.
If you chose to go on it, I have 2 pieces of advice:
1. Buy shitloads of moisturiser and lip balm. SHITLOADS.
2. BE PATIENT. Don't panic if it hasn't cleared you within the first 2-3 months. Took me nearly 4 before I stopped completely getting acne.
I know I sound like a broken record from other threads, but PLEASE be careful. I have bipolar disorder and my derm still concluded that it was okay for me to stay on my meds and take Accutane. My bipolar symptoms had been stable for years beforeheand and still did for the short period of time I was on it, however, I had such a horrible physical reaction about a month and half into it that I had to get off. There is never a real answer as to why the "rare" side of effects of Accutane can happen to people but my mood-stabilizing meds could very well have had something to do with it. Those with bipolar disorder have to be on meds for life as it's not curable, but even though those with depression can get off medication, I would be very cautious. But if nothing else has worked for you, best of luck. And make sure you have a good support system! 