From what my dermatologist has said, the strongest gel is tazorac. It is really similar to accutane in what it does to your skin to stop the acne, but without the side effects of accutane. I think it depends on how well your skin reacts to it on how well it does. I was on tazorac for what seemed like forever, and I had been on almost every medicine before that to treat my acne. My dermatologist told me to use it once a day, but I was still breaking out, so I then started using it twice daily, which REALLY shocked my doctor. The only side effect I had was that every once in a while my face would feel like it was on fire (I had to sleep with a cold washcloth over my face to make it stop), and that started when I loaded tazorac on twice a day. A lot of people get dry skin while on it, but apparently my face produces a lot of oil, so my face never got dry. I started taking accutane 5 days ago, and I am fine. All of my friends and relatives who have been on it basically have perfect skin now, and all said that I was going to LOVE what accutane is going to do for me. Their are a lot of bad side effects for most prescription drugs (listen to the commercials) and accutanes side effects really aren't worse. I really think you should reconsider accutane. I was on many MANY different medications for 3 YEARS before I got it, and I had to get a new dermatologist that would give it to me to get it (the one before said my face was not bad enough to get it and the one before that refused to prescribe it because of "legal issues." Examples of drugs that I was on: tazorac, differin, benzoclyn, monoclycine, metrogel, evoclin, bactrim, etc. etc. etc.
I've been on everything!