I dont feel that accutane affected my ability to make gains from a hormonal level but I personally struggled a lot with joint pain while on my 6 month course. Many people I know have no problems with this though. It affects everyone differently.
The biggest problem that I had, and this would have been increased by living in Australia, was the sunburn. If you are not careful you can get burnt very badly very quickly. I spent one morning at the beach and wasnt real careful and after that I could only wear shorts for a week as my lower legs were so burnt.