I have been on accutane 7 months. I was clear but now breaking out my doctor has increased my dosage to 40mg when will this start to kick in?

Varies. Different people metabolize drugs differently and their physiology varies due to their genetics. It may take 3-4 month before you see a dramatic improvement. Check out the following web site for skin hygiene tips. Best wishes. http://www.healthextremist.com/10-best-all-natural-remedies-for-acne/