You have to visit a dermatologist who will tell you if you are an "Accutane case" or not. If you have never been to a dermatologist, and go for the first time, they'll probably give you some topicals or antibiotics. Accutane is usually the last resort and is used when nothing else works. You can't get it without prescription because it's a medicine with serious side effects and not everyone can take it. You have to get your bloodwork done in order to know if you'll be fine taking it.