Appointments:

• Most people require the initial appointment and then approximately 3-6 follow up appointments (on average 5-6 for women, 4-5 for men)* but this number can be reduced in certain circumstances.

• A typical full treatment takes on average, 5-6 months to complete. A new appointment is priced at £189 and each subsequent follow-up appointment is at the reduced price of £149.

Blood Tests:

• Everyone will require a ‘screening blood test’ before they commence isotretinoin. This involves a Liver Function Test (LFT) and a Fasting Lipid Profile (LP). If you have known kidney problems you may be asked to book a Renal Function, also known as Urea & Electrolytes (U&E).

• These blood tests will then need to be repeated 4-6 weeks into your treatment course and every three months thereafter, while on treatment.

Blood tests are available via a few routes:

• Home blood test kits (over 18s only) - We can arrange for these finger-prick style tests to be delivered to you. We use a laboratory called Forth to run all our tests. These are priced at only £74.99. They also have an option where you can have your blood test taken by a healthcare professional in a clinic near you for only £119.99.

• Private Clinic - You may decide to have a healthcare professional perform these for you in a designated clinic. Most clinics will charge £200-300 but if you live near Fulham, London we can do them for you for just £95.

• Your GP - we can request your GP undertake your blood tests on your behalf although they are under no obligation to perform these as your treatment is being delivered in the private sector and not via the NHS.

Pregnancy Tests (women of child-bearing potential only):

• FREE! Skindoc do not believe women should have to pay extra, so we send you a pack with everything you need.

Medication:

• We are connected to an amazing online Pharmacy called Phlo Pharmacy. They are not part of skindoc, but they handle the majority of our prescriptions and have one of the lowest prices for isotretinoin in the UK. They also deliver your medication directly to you! Please note, that high doses are usually more expensive as more tablets are required, but the average is £25-100 per month.

A quick summary of costs would be:

• Initial appointment: £189

• Follow appointments: £149 (x5 on average i.e. usually monthly)

• Blood tests: Free via GP or approx. £225 privately (price based on 3x home test kits)

• Pregnancy tests: Free (if applicable)

• Medication: Approximately £25-100 per month (depending on the pharmacy) (5-6 months is the average for a complete course)

• Costs vary depending on how many appointments you need, if you get blood tests done privately, your dose of medication and which pharmacy you use but all in all a rough estimate for a six month course of 1:1 consultant-led treatment for a woman is in the region of £1200-1500 and £1000-1300 for men. Please note treatment courses for other conditions such as rosacea, folliculitis etc. can often last over six months.

*The reason women require more appointments is due to strict monitoring and pregnancy prevention, as dictated by guidance produced by the British Association of Dermatologists. Isotretinoin is a highly regulated medication, and we must abide by this guidance.

Isotretinoin (Roaccutane / Accutane) typically starts to show noticeable improvements in acne within 1 to 2 months of starting treatment. However, full benefits are usually seen after completing a course of treatment, which commonly lasts between 4 to 6 months. Some patients may experience an initial worsening of acne before it gets better, but significant and lasting improvement is generally achieved by the end of the treatment period.

Yes, Isotretinoin (Roaccutane / Accutane) can help get rid of blackheads by reducing the production of sebum, shrinking sebaceous glands, and promoting the turnover of skin cells, which helps prevent the clogging of pores that leads to blackheads.

You should take isotretinoin at the same time every day with a meal that preferably contains some fat. Isotretinoin is better absorbed with fatty food and so is more effective. Healthy foods that contain fats include whole eggs, avocado, olive oil and nuts.

Isotretinoin (Roaccutane / Accutane) generally stays in your system for about 7 to 10 days after the last dose, based on its elimination half-life of 10 to 20 hours. However, due to its lipophilic nature, small amounts may persist in fatty tissues for several months. It is crucial to avoid pregnancy during treatment and for at least one month after stopping the medication due to its high risk of causing severe birth defects.

Firstly, don’t worry. Isotretinoin stays in the bloodstream for over a week so it will not affect your treatment. However, do not try to make up for missing a dose by ‘double-dosing’ the next day. If you miss a day, you will end up tacking that days’ worth of medication at the end of the course.

Although not ideal, short gaps of approximately a week will not affect your treatment. We advise planning ahead as much as possible to avoid this and booking a follow up at least week before you are due to run out. ‘Emergency prescriptions’ unfortunately cannot be provided.

Lucky you! Although uncommon, some people experience little to no side effects at all. Ultimately, as long as the acne is improving that is the most important thing. If the acne is not improving then it may be that isotretinoin is not being absorbed properly so make sure you take the medication with a meal that contains fat as it improves uptake in your gut. The other reason may the dose is too low.

Although most people see an improvement within the first eight weeks it can take a while with some people not seeing much benefit for up to 12-16 weeks. This is uncommon though.

This will be discussed with you when you meet with your doctor however there are some skin conditions that may affect your treatment course. A good example of this is eczema. Eczema makes you prone to dry skin and since the main side effect of isotretinoin is dryness, it may flare your eczema. As a result, many people prefer to stick to a low dose (10-20mg per day) which although still effective, will prolong your treatment.

We don’t want to be party-poopers but ideally, no. This is because isotretinoin and alcohol are both eliminated by your liver and as great as livers are they don’t like dealing with both at the same time. If you must, you should ideally keep alcohol to an absolute minimum (less than the recommended 14 units per week) but preferably stop drinking while on treatment.

Isotretinoin capsules contain gelatin and beeswax so this may not align with your ethical and dietary beliefs. We can provide guidance on how to safely take the medicine without the capsule.

Isotretinoin is generally not recommended in people with established soya and/or peanut allergies. This is because isotretinoin capsules contain soya (which shares some cross-reactivities with peanuts). That being said, the amount of soya allergen in the soya oil is negligble and the amount of soya oil in isotretinoin capsules is tiny. Furtermore, the European Food Safety Authority does not require soya oil to be be declared as it is not considered an allergy risk.

Successful treatment has been acheived to people with soya and peanuts allergies, however it is generally best to avoid this medication if you are known to have an anaphylactic reaction to either. You may want to consult with an Allergist beforehand to check you are safe to use isotretinoin.

Yes. Although always look at the RDA (recommended daily allowance) of Vitamin A and ensure it is not over 100% (>5000 units) per tablet. Isotretinoin is a synthetic derivative of Vitamin A and can cause supplementary Vitamin A to build up to toxic levels (known as hypervitaminosis A) which can make you unwell.

Whilst taking isotretinoin, and for six months afterwards, your skin will be more delicate than usual. The jury is out on this but hair removal using waxing, epilation, dermabrasion, or laser treatment, as well as tattoos and piercings, should be avoided for those six months - although many practitioners will undertake procedures after only two months. It is best to check with your provider and why they are happy to reduce the wait. The evidence is lacking here but there are reports of scarring and poor outcomes when performed before six months.

The association between isotretinoin and atypical wound healing remains controversial. It is common practice to delay elective or non-life-threatening procedures for six months as isotretinoin may impair wound healing or induce hypertrophic (thick/raised) scarring. However, more recent research would suggest otherwise. It is therefore important to discuss the pros and cons with your surgeon and if it is reasonable to wait until your course has completed and your skin has returned to normal.

Shaving is normally tolerated, but since your skin is more delicate using a non-pore-blocking moisturiser afterwards is advisable.

Yes. This is to ensure the triglyceride levels are accurate. Fasting means you should not eat or drink other than water, black tea or coffee (no sugar) for 8 hours beforehand.

No. You must not donate any blood products while you are on isotretinoin treatment and for one month after you have stopped it.

There are plenty of other options including a wide range of topical agents and antibiotics. Some females may also be eligible for the off-licence treatment Spironolactone depending on their type of acne. The appropriateness of alternatives will need to be carefully discussed with your doctor in your consultation.