It doesn't only act like high-dose Vitamin A. It also downregulates androgen receptors and affects production of DHT and other androgenic metabolites, so it is has multiple anti-androgenic activities. I found a great post that breaks down the different anti-androgenic mechanisms: How Accutane can cause similar effects if it is not an 5AR inhibitor?
The other thing accutane is known for, usually in a positive light, is the enduring nature of its effects. Many people will never be as susceptible to acne again for the rest of their life as they were before the course of accutane. This seems to suggest a degree of permanence for not only the positive but also the negative effects of the drug.
