Hi guys, I'll try to make this short as much as possible. Thank you for bearing with me. I appreciate any advice/comments and I'll try to contribute back with my own experience/knowledge/advice.
I just recently went to my 2nd dermatologist appointment today. The 1st one was a different doctor and about 1-2 years ago.
I had HIGH hopes today, because at this point, I'm getting desperate. I'm tired, honestly. I'm tired of having this acne for over 7 years with it being almost at its worst right now. It's always been severe for me. It's painful, it hurts to constantly accept the fact that I don't have a clear face like others. It hurts to have this HUGE insecurity that I try to cover by wearing BB cream and I am a damn guy. I don't want to go more in detail about my sob story, because I understand that there are others with the same situation or that have it worse.
So today, I had HIGH hopes, because I was SOOO ready to be prescribed Accutane, the one drug that supposedly has the highest success rate. I believed that it was my last chance/option of winning this battle against acne. Ever since I stopped using minocycline and tretinoin, which did not work for me except clearing my face for 3 weeks (best 3 weeks ever), I developed trust issues for drugs other than accutane. I really feel like the only drug that will work for me now, is accutane. I thought that today, would be the first day of a NEW journey on the right path to actually beating acne. Before waiting a month in making this appointment, I had made another appointment, 3 months in advance, with another dermatologist, only to go there and hear that my insurance is not accepted when at first, they said they do accept when I made the appointment. So I thought today was the day, but I guess not...
The dermatologist (she was kinda rude tbh, didn't seem interested and even laughed randomly) told me that I would have to go on doxycycline and retin-A for 3 consecutive months before transitioning into accutane. The reason for that is because it was my insurance's policy. I told her that I had already been on tretinoin and minocycline for a year and stopped, because it didn't work. So why would I have to go back on to a similar treatment? However, she still insisted that I will most likely get denied in getting accutane, because it is my insurance's policy. In order for me to get onto accutane, I must be on doxycycline and retin-A for 3 months. SO, leaving with a prescription of those medications and a feeling of being scammed, I went ahead and called my insurance company. Coincidentally, the person I talked to was honestly pretty rude. Long story short about the call, the person gave me a VERY unclear answer to whether I can go onto accutane without getting on retin-A/doxycycline since I have already taken tretinoin/minocycline. She also said that the reason why I can't is because of safety reasons (?) and that I must exhaust those drugs first before going on accutane. In the end, she just hung up on me....
So guys, what do you think I should do? Should I call the insurance company and try to reason my case again? Should I change my insurance, which could result in my finding a different dermatologist that can take months?
Or should I actually get on the retin-A/doxycycline treatment for 3 months, before going on to accutane? I don't know, maybe I shouldn't rush into accutane so fast. Maybe I should give doxycycline a shot. You know, I believe accutane could be a miracle drug for me, but at the same time, I have a feeling that there's a chance it won't be right for me.
I don't know what to do guys, please help....... 
Thanks guys.......
Minocycline worked for me, but I didn't want to stay on an antibiotic forever. The way I looked at it, (and fortunately, the way my derm looked at it, too) was that there's no point in keeping on with other medications when my acne will always inevitably come back after I come off of it. I wanted to try something that would have a good chance at permanence, and for me, that's Accutane.
That said, three months is a really short amount of time. Even if you started Accutane today, you might not even be clear by then. Try the other meds out. Satisfy them, and if you still want to go on Accutane after the three months, go for it! Plus, the fall is a great time to start Accutane. You don't have to worry about the sun sensitivity quite so much.
Thanks for the replies guys.
I mean, I am thinking hard about exhausting other options first before I move onto accutane. But I'm worried that being put on Retin-A/Doxycycline will make my face even more worse than it is now (my face would literally just be one giant, nasty, bumpy, pimple) and NEGATIVELY affect the accutane treatment after. I don't know... I'm thinking that I should do accutane as soon as possible.
But do you guys think that for 3 months, there should be no risk to try out Retin-A/Doxycycline before immediately going on Accutane?
Is Accutane more harmful and powerful to the body than the Retin-A/Doxycycline combo?
Seriously thanks for the replies guy. Would appreciate even more if I get more replies back from you guys.
If you're really set on taking Accutane, I'd say you should try calling your insurance company and asking again, this time with a different person. After all, this whole fiasco started because of a miscommunication that ended in confusion as to whether or not you'd be covered. Especially since there seems to be a lot of ambiguity in their explanations even now.
In my personal opinion, though, I'd say it wouldn't hurt to just go ahead and go on doxycycline and Retin-A for another 3 months. If anything, you can just consider it to be preparation for Accutane, since it seems like you don't think these new prescriptions will improve your acne much anyway. After all, you know your own skin best. Considering all the years you've had acne, another 3 months is probably not that much time to endure. And I can really sympathize with you and your distrust of most acne treatments, since I've also suffered from acne for 9 years now, and have been on all sorts of treatment combinations, including benzoyl peroxide, antibiotics (both topical and oral - including both minocycline AND doxycycline), and retinoids (including tretinoin). After having been through tretinoin/doxycycline combo for 6 months and then spironolactone (a hormonal diuretic) for another month, I've finally decided that enough was enough, and that I didn't want to be on antibiotics or pills for the rest of my life even IF my skin were to completely clear up, which it hasn't. It's not even healthy to stay on antibiotics anyway. At this point the only types of medication I haven't been tried now are birth control and Accutane, and this is the truly the point where I've exhausted my options. I'm not saying that you have to go to the extremes like me haha, but since you're already one step away from going on Accutane, I'd figure, why not just take the leisure to finish that last step before you finally go that route? That's what I've done, and now I can confidently say that I will never look back now that I've finally got myself started on Accutane. I don't know what the consequences will be but I know it'll be a step forward from where I was, at the very least.
But in all honesty, it's up to you. I think it's also worth fighting for what you believe in, and if you've already been on a retinoid/antibiotic combination with Tretinoin/Minocycline and really think it won't be worth it to go on Retin-A/Doxycycline, you should try and talk to them once more and try to convince them...
And as for your previous questions regarding your concerns for Retin-A/Doxycycline, I can tell you that it really wouldn't negatively affect your Accutane treatment or be any risk to it. Accutane is by far more powerful, with results that can last for the rest of your life. While Retin-A affects your skin (on a surface level) by encouraging cell turnover and maybe even reducing some oil production, Doxycycline aims at the bacteria in your pimples (but of course, it still affects other bacteria than just the P. acnes on your face). Accutane, however, targets all of these causes of acne and more, on a much deeper, cellular level. And the side effects can vary, depending on the person. It's definitely something to be taken more seriously than the other treatments, to the point where you'll have to sign a contract, be strictly monitored for the entire 4-6 month duration of the course, including going on monthly checkups and taking monthly blood tests for liver function, refraining from drinking or smoking, and, if you're a girl, taking pregnancy tests and going on multiple forms of birth control in order to prevent any chances of pregnancy. Some dermatologists will even have you go on exercise and dietary changes as well, as my friend's dermatologist did. Luckily as a male, you won't have to bother with the pregnancy/birth control risks, but nevertheless if this is something you're prepared to go into right away, I'd recommend you try to see if you can talk to your insurance company once more. If you need a bit more prep time in order to transition (ex., research ways to deal with side effects like dryness, or quitting any unfavorable lifestyle habits), then I say you might as well go on the Retin-A/Doxycycline treatment course in the meantime. Just do whatever you're most comfortable with, since I am see that you're sort of on the fence with both options. This is just my 2 cents, anyway. Hope that helps!
