Ideally, I would run accutane while off gear. It is a highly toxic drug and it's a good idea to have as little stress as possible on your system. If you are going to use it while on, I would avoid any form of oral steroid while on it. A dermatologist would have you run a several month course of accutane, building the dose to around 80mg ED. I have used it through a dr, as well as on my own and had my own labs done through the process. When I ran it on my own, it was several years after having taken it through my MD. I started at 20mg ED. then went to 30mg ED about 2 wks later. Then went to 40mg and stayed there for about a month. I believe I ran it for 2 months, all together. It was enough to make a vast change in my skin and it has stayed clear since. Keep in mind that on my second run, my acne wasn't as bad as it was the first time I ran it. Years ago, acne was bad for me. I went to the DR and got on accutane eventually, after trying everything else. After using it for several months at 80mg, getting labs done every month, the acne cleared. Then over time, say 8 years, it started to come back and thats when I ran it on my own. You'll still want to follow the other advice I've given in the Q/A, as far as showers, antibacterial soap, clean sheets and pillow case, ect. On top of that, you will need a good hypoallergenic lotion because you skin will get very dried out. Stay away from tanning.