Accutane is like an athlete or team who only performs best when faced with a tough challenge. When matched with brutal cystic acne, nodules and large pustules, Accutane does a great job. With smaller lesions, such as papules and small pustules, it also performs well. However, Accutane is a paper tiger against blackheads; mild improvement but not even as well as topical Retin A.
As usual I agree with Dr. Chen that manual extractions such as found in a deep pore cleansing would be very therapeutic. I would add salicylic acid peels to the regimen.



