I am 27, female, 50kg (110lbs). I took Accutane approx a year, daily dose of 20mg. Should I repeat the course?

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

Your dermatologist can determine whether you might benefit from another course of accutane depending on several factors, including issues related to your periods, severity and extent of acne, etc.  I suspect your overall cumulative dose prior was insufficient, and that repeating it would be a reasonable thing to do in your case. Some people think Accutane is a "1 shot deal", but often people need to repeat courses if their dosing was too low, or they have complex/multifactorial/hormonal acne, or they took it at too young an age.

If you are having consistent acne this soon after stopping Accutane my assumption is that you didn't take enough of the medication to begin with. Taking 20mg daily for 6 months is only 3600mg. A normal cumulative dosage for a long-term cure is between 8000-16000mg total. I think you simply didn't take enough the first time."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."