You have stubborn, inflamed acne that isn't getting better with medicated creams and prescription lotions. Thinking isotretinoin (AKA Accutane) is your only answer?
Actually, there are other oral medications that may be helpful. Take tetracycline. It's the most common oral antibiotic used to treat inflammatory acne.
Tetracycline helps slow down the growth of the Propioni bacteria, the bacteria that's behind those inflamed breakouts. Getting that bacteria under control can be very helpful in stopping acne.
Oral tetracycline is usually used along with a topical acne medication, to give treatment extra oomph.
Besides tetracycline, other antibiotics like erythromycin, doxycycline, and extended-release minocycline (Solodyn), are used to treat acne. As always, your derm will help you wade through the oral acne medication choices to find the one that is the best option for you.
Antibiotics and Acne:

