If you go on accutane, you will probably still get an initial break out, but no one knows that for sure. If you have been on the retin A with good results, you may want to stick with it for a little longer. I am not a patient person at all, but I would give anything to remain even 90% clear with just using the cream or something. Give it a little time and if you still aren't satisfied with your progress, call your derm and ask your options. May an antibiotic with the retin A would help you?? And I do understand that you want to be 100% clear.......don't we all........but it sounds as if you made great progress already. How bad was it before??