My buddy tried it cause he got cystic acne on EQ. It made it MUCH worse. you are better off coming off the steroid causing the cystic acne or just not touching steroids than trying the accutane.

This is a month old but ill chime in. Here's my experience with accutane. Ive done many cycles with it. First one was while I was on TRT 150mg test cyp per week, accutane 20mg ed for 4 months. No change in liver or kidney values on blood work. As if I didnt take anything. It cleared my facial acne but did not touch the small amount of acne on my chest/back. When you first start using it every day, there is a period from the first 4 to 6 weeks where it sucks. The accutane pushes all the sebum out of your pours and brings it to the surface. You break out like crazy. I itched like crazy. My neck and head had acne and dandruff. You think its not working when it is. This is why there are a few rare cases where teens became suicidal on it. Made everything much worse. Fight through it, its temporary. Its working. After this period ends, the accutane shines. Your skin clears up. No more sebum causing the pimples and acne. New acne will pop up and disappear quickly. More side effects were the edges of my lips got dry, the edges of my nostrils got dry, so I used lip balm daily. Drank 2L-3L of water daily. Took the accutane with 15g of almonds every day or with a meal because it needs to be taken with fat. Not on an empty stomach. I bought Nizoral Shampoo and used it twice weekly and that solved the hair issue. That was on 20mg ed.
Then I ran Test 200mg/Primo 100mg for a cycle. Amazing cycle I respond well, but caused chest acne and back acne. Started accutane and went from 20mg first 4 weeks and the same purge happened, broke out like crazy and then it ended and accutane cleared everything up right away. Bumped up to 40mg to deal with the chest and back. After 2 months of 40mg it started to help my chest and back. Not fully cleared up but night and day difference. The extra side effects from 20mg to 40mg was a tiny more dryness for the lips and nose. Every day after work or after starring at screens, a little eye dryness but hardly noticeable. The dryness made it a tiny bit harder to see at night time. Didn't bother me that much. Test/Primo cycle ended, came off the accutane, no change in liver/kidney, all side affects went away. Good to go.
A year later I ran Test 400mg/Primo 200mg. Acne came back strong, chest and back. Diet was perfect. Started accutane again, first 4 weeks 20mg, then 40mg 4 weeks, then 60mg. When I bumped up to 60mg it got rid of my chest and back acne, but the dryness in my eyes was crazy. My eyes were so dry I was blinking a million times a day. Could not stop blinking. I had to buy eye drops and use them 6-8 times a day. Extra dry lips and nose I went through lots of lip balm. My vision at night was terrible. My sleep was terrible because I would wake up with the worlds most dry eyes needing eye drops just to go back to sleep. I also developed this rash on top of both hands and under both arms. Used Aquaphor to get rid of the rashes. After 2 weeks of unbearable dry eyes I completely stopped the accutane. All the side affects went away and my eyes came back to life. My Test/Primo cycle ended and made great gains.
So my limit is 40mg ed. I cant do 60mg because of the dry eyes. Many stories online say that if you keep using eye drops for the dry eyes and do this for months as you increase the dosage more and more, you will permanently damage your eyes and have dry eyes for the rest of your life and night blindness for the rest of your life from the accutane effecting meibomian glands in the eyes. It was painful just for 2 weeks I cant imagine the rest of my life. Clear skin is not with permanent eye damage. So I cant go past 40mg. Some can do 80mg or 100mg before dry eyes start.
Now here's where all my problems got solved with accutane. I watched a Vigourous Steve video where he had a Dermatologist named Steven Devos talk about accutane and here is what the doctor said. If you want your acne gone forever, you need to find your sweet spot dosage where you do not have serious sides, so for me that's 40mg, then you need to take accutane every day at that dose until you reach a total cumulative dose of 150mg * kg of body weight. Since I use pounds and not kg, that means 70mg per lb of body weight. If I was a person that ways 210lbs. 210lbs * 70mg = 14,700mgs total accutane. My safe dosage was 40mg every day. 14,700mg/40mg is 367 days. 20mg every day I would need to take it for 735 days. 60mg which is when I get dry eyes, that's 245 days. 80mg that's 183 days. I did not want to risk my eyes, so I did 40mg every day for a year. And boom, my acne went away forever. Permanently. No matter what dosages or types of gear I run. This is because accutane long-term changes the sebaceous glands, reducing their size and number. The glands responsible for producing acne, I don't have any. When I finished the year of accutane my dry lips and nose went away, oily hair came back, and now I'm acne free. Then I started to micro-needle the leftover scars until they reduced in size until fully gone. Now I have clear skin, no change in liver/kidneys, no permanent damage, lips and nose are good to go. The problem is doctors will say to teens and adults you need 120mg every day, to speed up the total process, but the patient doesnt pull back after the side effects they just use tons of eye drops and lip balm, and they permanently have those side effects. Not worth it.
So take 70mg * your body weight, find your sweet spot dosage, and finish the full course. Don't start and stop like I did, and 20mg ed is going to take almost 3 years so you need at least 40 or 60mg. Most people never take it for 3 years straight at 20mg so they never truly experience accutane finishing its job. And if you take it eod at 20mg it will take way too long. If you don't get chest or back acne and just face acne, then 20mg -40mg eod should be fine while on cycle. Once your cycle ends and the extra oil is gone you don't need the accutane. If you would rather not take it every time you cycle then do the full treatment. The video I watched is this one. https://www.youtube.com/watch?v=mAm8G_W-VLQ&t=730s
Good luck man. I'm thankful I did the full year and never have acne again, I'm thankful I came off when the dry eyes started and didnt permanently damage them. Listen to your body and you'll be set.

I’m not sure what I’m doing wrong but I’m taking 20mg twice daily. Never had acne issues until I started cycling. I always take after meals and maintain good hygiene practices.

I tried it last cycle and wasn't a fan of it...it was hell but I found washing with baking soda and using oregano oil worked well.

Works like a charm even at 20mg EOD. Worth the risks if managed and respected properly IMO.

My personal experience is 120 days of 10mg per day. Had pretty moderate cystic and nodular popping up on chest and arms. Cleared up and no reoccurrence. It’s been almost a year and I’ve been back on cycle for 7 weeks with no issues. 44 years old.

It's certainly the best medication for it, you'll have guaranteed results. I was in the same boat, hereditary acne since my teens, occasional outbreak while using AAS due to being 'prone' to it, tried every antibiotic, cream, ointment on prescription but the only thing that's ever worked is isotretinoin.
But it does come with risk, if you're unlucky enough to be one of the individuals who experiences the side effects of it you might regret it in the long term.

I made a post recently about isotretinoin and the recent studies / changes to prescribing it in the UK, can check out the full thread here if you like; https://www.eroids.com/forums/general/general-talk/isotretinoin-experien...

Short version is that more recent studies are showing a greater risk of long-term ED / sexual wellness side effects, especially in males.
In my case I certainly don't regret taking it, but it's something you need to seriously consider.

I'm over 40 and almost 4 weeks into running 25 mg/day. For the last 6ish months i've had some pretty bad cystic acne on my back/shoulders and a few red pimples on my chest. It came on last time i adjusted my trt dose and just wouldn't go away. I tried everything that normally works. Showering twice a day, always wearing clean clothes, either changing sheets twice a week or throwing towels on my bed/pillows and changing them twice week. All sorts of different antibacterial soaps and anti acne creams. None of it made a difference. By about the end of the 2nd week i started to notice that my back wasn't getting any new pimples. Now at the end of 3 weeks there is a definite reduction in the severity of my back though its still got dozens of pimples.

I haven't noticed the dry skin/lips most talk about though im using a really low dose. When i go and get more trt bloodwork in about a month i plan to check my liver values at the same time just to be on the safe side. So far this is the only thing that has shown any reduction in acne. But you really should try everything else first if you can.