I’ve never had the issue, I’ve heard it’s more likely with “dirty” or not sanitary gear.
I know you said besides Accutane, but I’ve heard good things about EXTREMELY low dose Accutane, like MUCH LOWER than the standard dosages. APPERANTLY this has little to no sides and still works well.
This is just something I’ve read somewhere, I have no research to support this and no personal experience. Normally wouldn’t have even replied, but as you have no other replies, I hope this helps a bit!