Second course Accutane and intial flare-up. Any suggestions?

I was on accutane (40mg) for 7 months one year ago. And now my acne has come back, right after Im migrating to Europe from asia. And my previous doctor prescribed me now 20mg per day with antibiotic topical and oral. Now I am one week on my second course of accutane and my acne is getting worse. I didnt get initial breakouts in my first course. So is it normal to be getting initial breakouts for second course? Or should I go for higher dose?

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