Is Finacea cream (Azelaic acid) a good substitute for Retin A for pregnant ladies with acne?

Good on you for doing your own background reading. I was wondering if it could be possible to cure acne without the medication? Taken in isolation, the answer to your question is yes. There are different severities of acne, each responding to different sorts of treatments. If it is acne of a severity level that warranted Accutane in the first place (usually reserved for moderate to severe, failed other types of treatment), then there’s a chance a topical regime may not be good enough. Having said that, hard for me to comment without knowing how severe your acne really is.

If I were in your shoes, I’d definitely NOT stop taking isotretinoin until I’ve finished the course. Many studies have shown that the risk of acne relapse is much higher if you don’t complete the course. The total dosage you need to take depends on your BODY WEIGHT as well. Tapering your dosage wise, please speak to your doctor. Again, if I were you, I’d just stick to the dosage that he has placed you on, since it appears that you are not suffering any adverse effects (apart from dry lips, which is very common).