None of these things helped my kids significantly enough to be worthwhile.. What often happened was something would work in the very short term, and then the effectiveness would wane. Very frustrating. When it gets to the point where your son won't take his shirt off to go swimming, something has to be done. I also wasn't very happy about the prospect of years on antibiotics for virtually no result. I think it's a decision that has to be made with care, but there aren't always a lot of side effects that go along with it. For us it was 100% worth it.
ETA: Just wanted to add that I actually regret not putting my older son on it sooner, because he ended up with a vast amount of scarring on his back. It looks like milia, but dermatology biopsied it and it turned out to be scar tissue. He has literally hundreds, if not thousands, of scar bumps on his back. He may be able to have his back peeled, but it probably won't remove the bumps entirely. If he'd gone on accutane a year or so earlier, he probably wouldn't have the scarring.
Former longhair, now CG, living in N. California where the fog meets the wind
3a/b, fine, normal porosity/elasticity, high density
Conditioner wash and style, sometimes with a dab of BRHG.