I have acne as a major problem prior to gear use. It actually is what brought me into the gear world as i searched for accutane UGL. Anyways, topicals don't do jack to stop the acne from coming up. It's very much impacted by hormones in 2 ways: fluct of them or high e2. If u can inject on a normal schedule and AI's ect.. on time each day or whenever u do, then it helps reduce sides major. And high e2 alone causes acne. Tend to see this happen often to woman alone and they start taking zinc (a very weak AI) and it helps the acne go away.
I take accutane however on cycle or off, around 40mg ED and have been doing so for so long. My liver according to bloods is proper and I do usually supp with NAC and liv52 anyways around and about. Especially when I take oral gear. I would not be scared of accutane, it is life changing for sure. Horror stories... there are some on every drug unless u suffer from major health issues already and know ur genetics are poor, then avoid accuane, but otherwise it's ok. The dry skin is nothing compared to acne all over for sure...plus it's a easy fix using common sense.
EDIT: for other users of accutane in UGL, incase it's lower dosed than normal or not working as WELL then I highly RECC: Taking 100mg zinc tabs (mixture, not elemetal pure) + eating high dietary fat at the same time u take it, enchances the accutane to work MUCH stronger. Since it's a version of Vit A, fat is needed for it to bind proper and zinc transports it. Keep it in mind, took me a while to figure this out after running some low dose stuff and since then it's been really helpful