Roaccutane

I am now on my 4th month of roaccutane 20 mg a day and I have not seen any improvement at all. I had a really bad break out though. Does this mean it is not working??

[loiloi]

Hi. Don't panic, Roaccutane results in excellent or total skin clearance in virtually all patients after 16-24 weeks. 20mg a day is quite a low dose though (unless you only weigh 40kg?).
Eloise.

[catwalk4]

I think it's great you are on that dose!  Most people don't see a big difference until 5 months (or later).  You will wake up one day and realize you have no active spots!

From FAQ:
What is ‘low dose’ treatment?  Does it work?
Low dose is usually 20mg per day or less, as low as 5mg per day of Accutane.  Treatment is usually longer (up to 18 months).  There is usually no or minimal side effects, and although not done often, it has had great success stories and seems like a great option for anyone concerned with side effects. 

What is cumulative dosage?
Many people will tell you it’s the cumulative dose that counts for treatment, and 120-150mg/kg overall has been found to be the most successful.  Here’s how to figure it out!  (mg per day) X (days on med) / (weight in kg) = CD.
So if you took 40mg per day for 1 month, plus 60mg for 5 months, and you weigh 70kg: (40 X 30) + (60 X 150) / 70 = 145mg/kg.

I'm assuming your doctor has you on it for 8-12 months, to do a full course for cumulative dose.  I've been on 10mg/day for almost 10 months and am totally clear with no side effects (lips are a bit dry, that's it).