Why do I have red patches around mouth after dropping Accutane dose?

Hi doctor,

I am currently on Accutane and have been on Accutane for a year and a bit, I was taking 20 mg a day and it was going well and my skin was completely clear. Then my dermatologist decided to drop my dosage down to 10 mg, three times a week, to try and ease me off the drug. As soon as the dosage dropped my skin started breaking out again, particularly around my mouth and nose. I was devastated and so I went back and am now on 20 mg a day again and have been for just over a month but nothing has changed, in fact, the breakouts have only gotten worse.

Now I have patches of skin around my mouth that are red, irritated and dry with small clusters of fluid-filled bumps which I assume are acne. The skin that is irritated stings, and is so dry it feels almost scaly, especially with the scabbing from the pimples or fluid-filled bumps. I am 18 years old, weigh around 132.28 Ibs and am now wondering what my next step should be? And wondering why the original Accutane dosage of 20 mg per day has not helped at all this time around.