If all other treatment options have been tried and failed then isotretinoin ((Ro)Accutane, isotane, etc.) is really your best hope. It is described as a "wonder drug" by some and others will tell you it is poison. If you do get isotretinoin then make sure you report ay side effects to your doctor, your doctor will monitor your blood with tests to check that your liver is functioning well. You can find some more information about isotretinoin at wikipedia.