Why Do IStill Get Massive Breakouts on my Last Month on Roaccutane?

Thank you for your question. Acne is a multifactorial condition and can be worsened by several things including stress or hormones. You may want to consult with your board certified dermatologist as he or she may have decreased your dosage of the medication since you are almost done with the treatment. If this is not the case then you may need to be placed on a 2nd course of Accutane in the future (6 months after 1st course). Other options may include getting a hormonal evaluation to rule out PCOS, and hormone therapy treatments such as certain types of oral contraceptive pills. Be certain to be under the supervision of a board certified dermatologist with expertise in acne for the most effective and safe treatment options. I hope this helps.

As stated, you may need more time on the medication. Discuss with your doctor.  The minimum effective dose for Roaccutane is  1 mg/kg/ day for at least 20 weeks.  If you are on a lower daily dose you may need longer.  It is also my experience that there are some adult hormonal acne patients, particularly women who will still need therapy after an Accutane course.  I often recommend Spironolactone with or without oral contraceptives depending on reproductive status.    Don't despair.  

Well it would seem then that you most likely aren't done with the medication and will need more month(s) of using it, if you're having breakouts like this at this point in time. Consult your prescribing physician. Accutane doesn't "stop" working, but you may need to be on the medication for longer than initially planned.