Unless you only get the occasional pimple, those creams like clearasil will do nothing. I took accutane when I turned 18, and it started to wear off about two years later. My acne didnt come back as bad, but it was still worse than I would have liked. Rather than going through the hell that was accutane, I searched for something else. It turns out that prior to accutane, one of the best solutions was high doses of Vitamin A. In fact, accutane is a derivative of Vitamin A. I started taking 400% of my daily value of Vitamin A, and within weeks I was once again acne free. Even at this percent studies show that it has no adverse side effects. Soon I found an even better product, called Akne Zyme, probably the best nonprescription product on the market for acne management. A daily dose contains 200% of your daily dose of vitamin A in addition to several other vitamins for skin health. It works extremely well without any of the side effects of accutane. While I don't know if it would work well on extreme acne, it sure does a good job on mild to somewhat severe acne.