Manual Exfoliants While on Low Dose Accutane?

Thanks for your question.
Accutane does dry out the skin and often leads to dryness, peeling, and / or scaling. Doing a manual exfoliation, or chemical toner / exfoliator may lead to a reduction in the appearance of dry skin, but may in turn cause extra irritation and redness. It's fine if you want to do a gentle exfoliation with a mild scrub, or even if you want to do a mild toner, just beware of this risk.
You will want to use a moisturizer as well to combat the dry skin appearance. My recommendations are simple: Cetaphil facial moisturizer wtih SPF 15 or 50, or you can even go thicker with Cerave moisturizing cream. These will help to repair your skin barrier and reduce dry lusterless accutane appearance. In regards to dark spots, time will help most, but a bleaching agent such as Hydroquinone 4% and sunavoidance will help speed up the process.
Good luck!

I find that most patients on accutane cannot tolerate additional drying or exfoliating treatments to the entire face so I usually advise against it because it dries the skin out even more. You may want to try applying a low-strength (2%) hydroquinone skin lightening product to the individual pigment marks with the understanding that you may need to apply it over your moisturizer if these areas become too dry. To help counteract the dull, dry appearance of your skin, use of a moisturizer with hyaluronic acid and dimethicone may help.
Good luck.