There is a good possibility that steroids could cause acne to return if you had it bad in your younger years. You could take accutane but you may not want to mix it with orals since accutane is said to be quite liver toxic. As far as the sides go, it depends on your doseage.
As lower doses like 20-30 mg/day, the sides should be pretty light. But everyone is different so the only way to know how it works for you is to start out small and work up.