Skin Conditions
Acne
Acne is generally treated with topical preparations, oral antibiotics, or isotretinoin. Other less commonly used treatments include vascular laser and spironolactone tablets for women.
A common reason for consulting a dermatologist about acne is to consider whether you may benefit from treatment with a course of isotretinoin (Roaccutane). Isotretinoin is an effective treatment option for severe acne when other treatments have not worked or if there is a risk of permanent scarring.
Following the publication of the isotretinoin implementation advisory expert working group report and the MHRA drug safety update, changes have been made to the prescribing and monitoring requirements for isotretinoin. Your dermatologist will discuss this with you in detail at your initial appointment.
There are particular implications for prescribing of isotretinoin in the under 18s, including agreement by two healthcare professionals that it is the most appropriate treatment.
Prior to your appointment to discuss your acne, you may wish to read the isotretinoin patient guide https://www.bad.org.uk/pils/isotretinoin/. There is also a patient guide for young people for patients under the age of 18 https://www.medicinesforchildren.org.uk/medicines/isotretinoin-guide-for-young-people/.
Further information regarding isotretinoin and mental health can be found here:
https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health-problems/isotretinoin-and-mental-health
As part of your isotretinoin work up and monitoring, you will be asked to complete various questionnaires relating to the severity of your acne and your mood. We may direct you to these resources prior to your follow up appointments once you are established on isotretinoin. Cardiff Acne Disability Index, Patient Health Questionnaire-9 (PHQ-9), PHQ-9 Modified for adolescents (PHQ-A).
You will be required to complete and sign the isotretinoin acknowledgement of risk form in your clinic appointment, useful links below. Under 18s are likely to need two appointments for the initiation process to be completed, and a parent or guardian must be present to sign the forms.
PHQ-9: Microsoft Word - PHQ9.doc (bad.org.uk)
PHQ-9 for adolescents Microsoft Word - PHQ-A.doc (bad.org.uk)
Cardiff acne disability index The Cardiff Acne Disability Index (bad.org.uk)
Other things to consider prior to starting isotretinoin:
Contraception:
All female patients of childbearing potential will be required to be established on contraception prior to commencing isotretinoin unless there is absolutely no risk of pregnancy.
Blood monitoring:
Baseline blood tests for lipid profile and liver function tests are required prior to commencing isotretinoin. The blood test will also need to be repeated whilst on treatment.
If you are a self-paying patient you do need to consider the costs of a course of isotretinoin. These are as follows:
Visit One
New consultation fee £195
Blood tests £180
Prescription fee £50 ( approx depending on dose) per month
Visit Two
Follow up consultation fee £125
Blood tests £180
Prescription fee £50 ( approx depending on dose) per month
Subsequent visits
Follow up consultation fee £125
Prescription fee £50 ( approx depending on dose) per month
The number of visits will vary depending on your status in the pregnancy prevention plan and the length of treatment course needed. Insurance companies will generally cover for a certain number of appointments, but not the cost of the medication.
The total cost can be expected to fall in the range of £1000 - £1500 depending on the length of treatment course and number of appointments required.
Some of the skin conditions we treat
Newcastle Skin Partnership has also written some brief skin condition guides to help you to understand these skin conditions and which treatments are available.
Two of the best websites for information on skin problems are the British Association of Dermatologists https://www.bad.org.uk/ and the New Zealand-based Dermnet website; https://dermnetnz.org/topics
DermNet (previously DermNet NZ) is the world’s leading free dermatology resource. We help thousands of people make informed, evidence-based decisions on how to care for skin conditions by providing reliable information at the click of a button.
British Association of Dermatologists (BAD), the professional membership body for dermatologists in the UK. A registered charity dedicated to medical education, research, and professional practice and standards.
