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Is it difficult to get a prescrip for Accutane?

I'm a 22 year old female and have had acne since I was 11. I have a tremendous amount of blackheads on my nose, and no amount of squeezing, exfoliating, or strips will remove them. I have about 3 pimples at any given time. I have two nodules on my chin at the moment. I also have a grouping of nodules/cysts that act up and become inflamed, then go back down, only to come up again. I also have papules and blackheads on my forehead. I have been on Differin, Aczone, Benzaclin, and minocyline, and am currently on BCP and have been on that for some time, with no improvement. I have used just about every over the counter product that one can imagine, and have found no improvement from those either. The nodules are extremely painful and embarrassing. I really want to go on Accutane and get rid of this acne once and for all (hopefully). My concern is that my derm will not prescribe it to me. He has always been very nonchalant about prescribing me any old cream that seems to come to mind for him that day, and none of them work. I switched derms this June and the woman I went to was extremely rude to me, I asked her about Spiro and she refused to prescribe it to me. She then prescribed me minocycline and accused me of lying about my weight (115 lbs...she thought I was heavier) when she asked so she could figure the dosage. I won't be seeing her again. I am a college student and I assume I won't have much luck getting a prescription for it at the school's infirmary. Would my normal doctor prescribe this to me? I'm at my wits end with these nodules, no topical treatments have any effect. My skin doesn't look terrible to these doctors so they don't take me seriously, but I think it is pretty serious when it has been going on for 11 years. How should I approach this with my derm or general practitioner? I don't want to have to rub a cream on my face twice a day for the next 15 years, esp when it won't even work. Thanks for reading if you have made it all the way to the end!

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