20 years for me as well, and over half my life with “post-accutane” PFS. Things seemed to naturally improve for me up to a high point between 25 and 30 years old, then a slow decline up until an ill-advised treatment attempt last Fall. I went the first 11 years believing this was a simple hormonal issue that could be fixed until putting the pieces together and realizing Accutane gifted me with this endless nightmare.
In the early years an endocrinologist suggested Accutane might be the culprit but I had never heard of such a thing as a permanent side effect and found it hard to believe the FDA would allow something capable of this to be sold to children.
This is just the way it goes. Some people get fucked in life and sometimes the ones doing the fucking become very wealthy in the process. The worst of it all is probably being laughed at in disbelief when explaining this condition to someone.