I used accutane for hormonal acne with excellent results many years ago, however, I found that after a year of being off of it, I had to go back on and took it a second time. Now that I am 45 years old and have diminishing estrogen and testosterone levels I recognize that my acne was hormonal in nature and due to an excess of testosterone. Spiro also did not work for me. Accutane is really good for deep cystic acne. Best of luck to you.