Accutane did not work for me. 7 months of treatment, two months to end the pill. Cystic Acne (Photo)

Accutane is a go-to medication for patients with recalcitrant cystic acne. It can reduce pore size and also reduce sebum production in your skin, making it less oily; and in turn, dryer. Accutane can be used to control acne, but patients receiving the medication should be carefully monitored. In terms of skincare, always wear an appropriate sunscreen and reduce direct sun exposure. In my patients, I recommend a good ceramide moisturizer such as Elevase whenever they are on Accutane. This will keep the skin hydrated and reduce the oiliness of the skin that is associated with oil-based moisturizers.

Best,
Dr. Karamanoukian
Realself100 Surgeon

If you are continuing to have cystic acne breakouts while completing isotretinoin (Accutane) course it may be related to a dosing issue. In general the total dose of isotretinoin one takes during their treatment course depends on their weight. However, for patients with ongoing breakouts higher total dosing than dictated by one's weight is recommended in order to achieve remission. Another possibility for why you may be having ongoing breakouts is that there is significant inflammation associated with your cystic acne. Reducing this inflammatory component of cystic acne often requires a course of oral steroids (Prednisone) along with your isotretinoin course and can have dramatic improvement if administered correctly. Finally, the type of isotretinoin can also be a factor in some patients not responding to isotretinoin as expected. There are different generic versions of isotretinoin on the market with some having a better absorption thought the GI system and thus better efficacy. A new formulation of isotretionoin called Absorica may be considered in cases of persistent cystic acne breakouts while on isotretinoin because it has better absorption than other forms of isotretinoin that are lipophilic and thus need to be taken with fatty foods for adequate absorption. I recommend speaking with your dermatologist regarding possible reasons for your lack of adequate response to isotretinoin treatment so far so that it can be addressed appropriately. 

accutane always works if it is managed properly.. it may not clear your acne in 3-6 months but if your doctor is very very experienced with accutane he can guide you thru  what it takes.

Acne scars are stubborn, and no single treatment is best for everyone. Various methods may help improve your complexion. Your doctor may suggest one or a combination of these.
Home skin care. The appearance of scars that change your skin color may be improved with over-the-counter bleaching agents and use of sunscreen to limit contrast.Soft tissue fillers. Injecting collagen or fat under the skin and into indented scars can fill out or stretch the skin. This makes the scars less noticeable. Results are temporary, so you would need to repeat the injections periodically.Laser resurfacing. This is a skin procedure that uses a laser to improve the appearance of your skin.Other energy-based procedures. Pulsed light sources and radiofrequency devices help make scars less noticeable without damaging the outer layer of skin. Results are subtle and you may need to repeat the procedure.Dermabrasion. This procedure is usually reserved for more severe scarring. It involves removing the top layer of skin with a rapidly rotating wire brush. Surface scars may be completely removed, and deeper acne scars may appear less noticeable.Chemical peeling. High-potency acid is applied to your skin to remove the top layer and minimize deeper scars.Needling or rolling. This involves rolling a needle-studded device over the skin to stimulate underlying tissue. It's a safe, simple and possibly effective technique for acne scarring. The result is subtle, and you may need to repeat the treatments.Surgery. Using a minor procedure called punch excision, your doctor cuts out individual acne scars and repairs the wound with stitches or a skin graft. Another technique called subcision involves your doctor inserting needles under the skin to loosen fibers below a scar, to help improve its appearance.Botox injections. Sometimes the skin around acne scars puckers. Relaxing the area with an injection of botulinum toxin (Botox) helps improve the skin's appearance. You'd need to repeat the injections periodically.
To determine what's best for you, discuss the pros and cons of each procedure with your doctor or dermatologist.