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This might be confusing, but here goes nothing. I started accutane in February, and I have taken 5 and a half months worth over the course about 7 and a half months. That may sound confusing, but I'll explain. In the city where my school is located, I was to start accutane and my doctor said I needed to take it for approximately six moths. I started accutane and took it for the first 4 months. Along the way, I got a little delayed, because a few days here and there I had to wait to get blood results back before I could get it refilled. THEN, I had to go to a different city for the summer for a summer program. I didn't want to travel all the way back to the other city to see the doctor, so I transferred to a new doctor, temporarily. This doctor said that it didn't matter how long I took it, but THE TOTAL DOSAGE mattered. So she did math, and said that this 5th month that she was going to prescribe to me was the last I needed. Fine. Everything is okay. So I go back home and transfer back doctors to my original city, and she said it would be good if I took one more month. Fine. So I start on the 6TH month, but after one week, I quit. For 3 weeks, I didn't take any accutane. I was sick of the hairloss, the depression, and the skin dryness. So after those three weeks I go back to the doctor and she asked if I had any new breakouts and I said I thought I MAY have had one on my back. So she says "You need to keep taking accutane until it has been 2 months since you had a breakout." I was about to scream. Who do I believe? Doctor A or Doctor B? Was I supposed to stop like Doctor B said after the 5th month, or do I keep taking it until I haven't had a breakout in two months? I just started accutane again after being off of it for 3 WEEKS. And my hair is falling out more rapidly, my lips and skin are getting dry again, and I feel awful. Do I keep taking it? Or do I stop. The main thing I am worried about is that my skin will get oily again. During the three 3 weeks that I stopped it, it was the perfect level. Not oily like it was before, but not dry. Would it have gotten more oily than that? I hope not! I hope that will be the way my skin stays when I am finally off of it.
I'm on accutane, been using it for the past SIX months already and I'm still on it. My doctor believes it's the cumulative dose that matters and says that is what's published... That reaching a cumulative dose of something like 120-150mg/kg is what is needed for acne to go away and stay away. I may be wrong about this range it's been a while since I asked about doses of accutane. I've been using 20mg/day because that's just what he wanted and apparently higher doses give worse side effects so even though it will take longer to get there it's less difficult. i can't actually remember the last time I broke out but I still have to finish my course. He was even saying on my last visit that he might drop my dose since I do have side effects at this low dose.
What I can tell you about stopping accutane after you've been clear for two months... I know one person who was on it for 4 months. She was clear after maybe the first few weeks. She only had mild acne to begin with. So the doc took her off it and less than a year later her acne came back. I know another person who took it for about 6 months and finally gave up because his acne wasn't going away. But it did gradually after he stopped. I don't know what dose either one was using but saying 2months after you're clear doesn't seem as scientific as reaching a cumulative dose.
One of these doctors needs to calculate how much more you need to reach the desired cumulative dose and put you on a small amount until you reach it. if you're already in a low dose and still having side effects then you should probably stop. But if your dose is large then ask for a low dose.