The honest answer is, there's really no alternative to Accutane. Accutane is the most potent drug available for acne treatment and the only drug proven to control severe and cystic acne long-term. Having said that, people with mild to moderate acne should start their treatment with effective topical anti-acne medications such as MDacne that contain micronized benzoyl peroxide. By using (and committing to) topical treatments that are personalized to the user’s skin, there is a significant chance for skin improvement without the need for oral medications such as Accutane.
However, people with moderate or severe acne that do not improve with topical treatment alone should consult with a doctor or dermatologist about adding in an oral medication such as Accutane.
Here are some additional resources on Accutane you may find helpful!