I've known five or six people who've taken it, none with serious side effects, and all with significant and long-lasting improvement in acne. This includes both my sons, one of whom is also hypothyroid and on meds. Topicals and antibiotics had very little improvement for either of them (facial and extensive back/chest acne), so accutane was our last resort. They had the usual dry skin/chapped lips, but no hair thinning. For them, their acne was 100% gone and has remained so except for the occasional small spot for nearly six years for the elder and four years for the younger. Both were monitored very carefully while on it. I wouldn't recommend it for mild acne, but it does work and usually does last.
3a/b, F, normal porosity

I've gotten my routine down to the bare essentials, finally
Wash: Suave Tropical Coconut
Leave-in: Suave Everlasting Sunshine, detangle with Denman brush
Gel: LAL Sport or Wet Look
Scrunch with flour sack towel, plop 10 minutes, air dry
Refresh with either plain water or Suave/water mix