I don't think you can insist on seeing a dermatologist if you are going the NHS route? You can certainly request it, but I do think its important to understand that GPs are basically required to try other treatments before referring you. The prescription guidelines also make clear that roaccutane is for acne that has not responded to other treatments, so people should not expect to stroll in for the 1st time and demand to be referred to a specialist without having tried other medications. (I guess this might happen for extremely severe cases). This may not be what most patients are considering but remember that isotretinoin is a really expensive drug, so it won't be handed out on the NHS without them being sure that it is the best course of treatment.
I absolutely agree that if you are going to see your GP then be upfront with the emotional / psychological effect acne is having on you. If you are a borderline case this may well get you the referral.
Of course you always have the option to go to a private dermatologist and pay for the convenience if you want to 🙂

Than you for that welcome clarification, you are correct to challenge my use of the word insist. As yourightly point out, a referral to a dermatologist should only be made once the GPs range of treatments has been exhausted.

When using the NHS, you must be diligent and persist with your GP and continue to go back if the initial treatments do not work. If at that pointyour GP is unwilling to make a referral, perhaps because they do not consider your acne to be an important enough issue to justify the expense, I think it would be sensible to make such a suggestion yourself.

3 hours ago, Gerry123 said:

When using the NHS, you must be diligent and persist with your GP and continue to go back if the initial treatments do not work.

Oh yes, absolutely the best advice! When I was a teenager I was given tretinoin cream and put on the pill. They didn't really do anything for me but because I didn't even realise how many other options there were, I never went back to request something else (and I was young and embarrassed of course). I do wonder if I had persisted how many years of angst I may have saved myself?

I live in England and I booked an appointment to see a very good dermatologist because I knew the NHS has a long waiting list.
The dermatologist asked about my history and he said accutane would be a good solution for me. He explained to me the cost would be over a grand for 6 months treatment, so he decided to transfer me to his NHS clinic within a few weeks and not do the treatment private. That was really nice of him, i wasn't expecting that.

Thank you for this thread Gerry123 I'm also in UK & as I couldn't afford private treatment I had to exhaust my NHS GP practice before being referred to a Dermatologist. Plus, the GP's seemed to differ on what methods had to be taken before referring me. One said all the topical lotions & 3 seperate courses of different anti biotics, for at least 6 months at a time - *this to treat a hormonal problem (eye roll). My Derm confirmed that only two different anti biotics need to be tried & tested until a referral can be granted.
Bottom line is, when you are either looking for the referral or in the actual Dermatology clinic, use the terms "affecting my quality of life" and "affecting my work". Buzzwords.

I agree, acne is still seen as trivial by most. By all accounts it is in certain situations of course. But it's treatable. To go via NHS you just need to be really firm & commit to getting noticed.

On 3/5/2016 at 1:44 PM, Gerry123 said:

Hello all

As a long term reader of this forumand, as most of us are, veteran acne medication user, I write this note to provide other acne sufferers with information on the process of obtaining Accutane in the UK, something I should have done years ago.

Like most, my acne was at its mot severe during my teens, predominantly 14 through to19. During this time I contacted my GP on numerous occasions and was put on a variety of antibioticand treatment creams. It is difficult to say whether any of these had anoticeable effect because my acne was ever changing, all I know is that it did not clear it up, and it persisted into my twenties. The main issue preventing my acne being taken seriously by GPs was the fact that it was always moderate with the occasional cyst. Although it was unsightlyand embarrassing, it never crossed the 'severity' threshold to consider me for deferral to adermatologist. Now, without disparaging GPs as a whole, I think it is quite uncontroversial to say that the average GP does not understand the psychological impact that long term acne suffers face. Generally GPs were dismissive, viewing myacne as a transient teenage problem. The problem with that view is that it does not take account ofthe mental toll that acne sufferers face. These early experiences put me off using medical professionals for treatment and I looked elsewhere to find treatment options

From around the age of 20 I was consistently using benzoyl peroxideas part of the Regimen,and for a period of around 6 months during the initial usage I experienced a significant reduction in my acne. Then, as though by magic, it stopped working.The only real 'cure' for my acne is sunlight. An hour in the sun every day will generally clear it up. However the reality of a stressful office job is that this is simply not feasible most of the time.

After much research, and now being at the age of 24,I decided that Accutane (isotretinoin)treatmentwas my last option. As a controlled drug, Accutane can only be prescribed by a specialist dermatology consultant in the UK. The prescription guidelines state that Accutane should only be used for the treatment of severe acne, however they also state that it can be prescribed if the acne is having a significant psychological impact.

I researched several clinics in the UK, andinitially booked anappointment with Botonics in London, mainly because they are one of the only private practices offering Accutane as a treatment on their website. However to save cost, I later contacteda private dermatologist at a Spire hospital in Leicester. The dermatologist I saw was professional, insightful, and listened to my concerns with empathy. She then recommended Accutane. Importantly, the dermatologist understood acne can be psychologically damaging and was willing to read the prescription guidelines in light of that fact.

So my advice, to anyone considering seeing a doctor either in the NHS or privately, is toinsist that you speak to a dermatologist.This is more important if you are obtaining treatment through the NHS as private dermatologists can be contacted without a referral. Also do not be embarrassed to disclose that acne is affecting your quality of life. If youmake this clearenough, the dermatologist will be willing to look beyond the physiological severity of the acne and understand your prescription needs when read in conjunction with the psychological impact it is having on you.

I hope this helps.

Hi mate,

How was your experience of roacctunane?

My situation sounds very similar to yours but am I 33. So sick of acne and psychology impacts, I feel like I put my life on hold for it. 99% certain Im going to see a private derm and ask for tane