There comes a point that topicals don’t work. You are the only one who knows if you have an actual problem or you’re just being dirty.
Steroids make your sebaceous glands work overtime. This means they’re producing more stuff than a normal person and it’s going to give you clogged pores, ingrown hairs, and as a result, more acne.
All the creams and scrubbing bars are just a bandaid to the fact that you are basically a sponge oozing out oils and gunk.
Accutane helps to shed the dead cells and stop them from clogging you up. It also shrinks your glands substantially which will stop all that oil buildup from happening in the first place.
It’s not safe at the dosage most doctors prescribe it. But there have been studies showing a fraction of the doses yielded the same results with minimal damage. Treat it like any other steroid. Start low, monitor your bloodwork and sides, and don’t take it for too long.