More than 3 months on Accutane and Breaking out huge pimples and cystic acne like crazy. Is this normal?

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

Remember that Accutane works underneath the skin, so many papules, pustules, and acne cysts are pushed to the surface while the under pores are changing. This can be frustrating, but all of that was under the skin and going to surface at some point in time; it's just happening all at once from the Accutane. Accutane doesn't cause scarring, but acne does. Many people don't realize how bad their scarring was under all the existing acne and start to see it as the Accutane clears it up. This isn't from the Accutane, but the scarring is from the acne that was already occurring. Your face doesn't have to be dry for Accutane to work. Hang in there. And discuss your concerns with your treating physician. As well as how to address your scarring in the long-run. "This answer has been solicited without seeing this patient and
cannot be held as true medical advice, but only opinion. Seek in-person
treatment with a trained medical professional for appropriate care."