I run a community forum and have done so for over ten years. Spam accounts is a regular occurrence, but thanks to various services (akismet, stop forum spam), captchas, and simple word / behaviour filters (anyone with <10 posts that tries to post a link or image gets flagged) we've been able to avoid our users from seeing much spam. There's a few that come through, I wonder if those are real people.
Anyway, at one point we decided to just block the IP ranges from countries like Russia and Vietnam, which seemed to have the most spam accounts.