What you describe is normal. You should discuss your concerns with your doctor. Flares are normal in the beginning. Depending on your weight, acne, and tolerance, you will most likely need a higher dose eventually.
Not every patient has excessive dryness with Accutane. It does not mean that you won't continue to become more dry. If you are still having acne break outs (which you can have the entire course of the treatment) then discuss this and your concerns with the prescribing physician....
You need to be on TWO forms of birth control if you are taking Accutane and are of child bearing potential. So, yes, take your birth control pills! "This
answer has been solicited without seeing this patient and cannot be
held as true medical advice, but only opinion. Seek in-person...