1) Is there such a thing as Differin dependence: No.
2) Will your acne worsen as you wean yourself off medication? Yes, that can happen. So first of all your medications have to be weaned off gradually and your doctor may overlap your oral medications with topical medications during this period to cut down or totally stop your oral medications. Treatment of comedonal acne isn't so straightforward; it can require a more holistic treatment for example, with changing your skin care and combination treatment with chemical peels and lasers. I have managed to wean off patients without purging or worsening of acne through a gradual process; so speak to your doctor to see how you can wean off your meds without worsening your condition.
3) Do you have to use Differin for life: No.
4) Safe to undergo comedone extraction during the purging phase? No. The purging phase occurs when your medications are working- so when Roaccutane and Differin are accelerating your skin cell turnover, it brings the tiny comedones that you might not have noticed called microcomedones to become more obvious. It's a frustrating phase but you'll have to hang on. Extractions have not been found to improve or shorten the purging. Extractions also carry a risk of making your pores larger and cause scarring.
