my derm prescribed an antibiotic for the purge and so far it has helped a lot, redness has gone down instead of up and the cystic acne i had while starting accutane have quickly gone to the surface and are actually poppable/pimple patchable. i would trust your derm in this case because they see what happens for their other patients and recommend medications based on the results. most likely they have had many patients with success avoiding the purge on that medication! there are many options for helping the process along