I have been off and on birth control for about 9 years and I was worried if I stopped taking the pill when I stopped the accutane that I would get some horrible breakout or something, but my dermatologist wasn't worried and said it would be fine. Anyways I ended my pills right before my accutane finished and I did not get any breakouts up until recently (I ended tane in August). Actually I can't even call it a breakout compared to what I had, but I have been getting the odd blemish here and there and it's pissing me off, but I don't think it's hormonal, as they aren't big and painful and not during time of the month. I think accutane wouldn't "allow" a breakout like your skin can't physically produce a pimple after accutane..at least initially. Even my pimples now a few months later are almost "empty" feeling and go away quite quick. I think it would be the best time to stop the pill because accutane will keep the breakouts at bay, but I don't think you would get any especially on your second course.