Initially when treatment with capsule isotretinoin 10 or 20 mg is started there can be an initial flare(increase) of acne and it is nothing to worry about. The severity of acne dictates the choice of treatment. In the early grades of acne even the cream might suffice however in moderate to higher grades tablets also need to be taken. The treatment has to be continued for a few months otherwise the pimples would tend to return easily. Kindly do not self medicate without professional advice as that could further damage your skin. Get an online consult privately with pictures or meet a dermatologist directly for a proper evaluation of the condition. Hope this was helpful.