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Accutane is a retinoid. Retinoids cause skin cells to grow incredibly quickly, and as they do, they can get trapped in the pore ducts causing comedones (those bumps known as whiteheads and blackheads) to form.
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The initial breakout is just one of the very mild side effects of taking Accutane. If you experience any other side effects, particularly changes in mood, be sure to discuss them with your doctor. Also remember that Accutane is a pregnancy class X drug known to cause severe birth defects. Women should either abstain from sex or use contraceptives while taking this medication.