Has anyone been prescribed isotretinoin privately?

[MeadowHay]

Wasn't sure where to put this...I have acne, have battled it since adolescence, I'm in my mid-twenties now. The only time I have been acne free really was the second half of my pregnancy. I'm pretty sure I have tried every primary care acne treatment at one time or another and GP has referred me to dermatology for isotretinoin (accutane). That was a month ago and my NHS appt is not until May. I am going through a particularly bad patch of it atm and am getting new scarring every few days on top of my scarring from a few years ago. I feel sick with a anxiety about it. I contacted a local private hospital for a quote and they said the initial consultation would be around £150 but would not give me any further quotes. I need to know roughly how much it would cost for the entire treatment service before I could consider whether we can afford it or not.

Has anyone done this privately? How much did it come to in the end? I am in NW England.

It would be cost price privately. I haven’t got a BNF in front of me but maybe someone else can check.

Would I not need x amounts of follow up appts too though? And would they want to prescribe anything else? E.g. contraception, would that need to come from them or I would just need to sign to say I'm on it?

I'm currently taking Isotretinoin funded by the NHS. Can't you try that way?

You need a follow up appointment, blood test and pregnancy test each month

I asked for a referral in May and got an appointment for December.
I emailed (very nicely) and begged if there were any cancellations could they consider me.
The next day the consultants secretary called and said come in the next day. I was so desperate I cancelled all my meetings and went. Worth a shot! A GP friend told me this was a good tactic.
Roaccutane has been the single best thing I've ever done (children aside). Good luck OP.

ImBlue - I've been referred a month ago but the dermatology waiting list here means my appt is in May 2020. Meanwhile my face is becoming more and more scarred as each week goes by but by the sounds of things I don't think I can afford to go privately if you need all those extra appointments and bits and bobs. I could try calling for a cancellation but honestly the doctors have warned me about the state of the waiting list here and there are people with very painful worsening skin infections etc who are still having to wait 6m+ for an appt so I really doubt I have any chance of getting one sooner

I’ve done it privately. You need a consultation and a pregnancy test each month and blood tests but not every month. My consultant was happy with a pregnancy test I bought myself which meant that cost £1 rather than the £25 the private hospital would have charged. The drug itself cost about £50 a month. It’s usually about 6 months. My GP was happy to send my bloods for me so I didn’t pay for them but bear in mind they don’t have to do that so you’d have to find out how much that costs. The initial consultation fee with my consultant was a bit more than the follow ups so it won’t necessarily be £150 each time but you’d need to check.

I went privately for convenience of appointments- I had a course on the nhs a few years ago but because the appointments are so frequent it’s quite difficult to fit them around work. I saw the same consultant privately as I did on the NHS, it just meant I could make appointments in the evenings. There was no other benefit to going private, the treatment is the same otherwise.

Also, as long as they’re satisfied you’re on contraception, it doesn’t need to be prescribed by them.

Yeah the only reason I want to is so I don't have to wait til May and have my face become more and more scarred not because I think it will be better care or anything like that. But I don't think I can afford it if you have to have monthly appts etc. Thanks for your help everyone anyway.

Not as strong but have you considered tretinoin? You can get an online prescription from dermatica for around £20 a month. It might help things enough to prevent scaring until May.

Not everyone insists on monthly appointments. My dd - a student had her blood tests done at her gp to cut down on costs. Unfortunately the absolutely crap derm. at Spire hospital insisted on seeing her every month even though half the time she hadn't even got the blood test results.Our local skin clinic were happy not to see her every month but were very hot in checking up on the blood tests and talked her through the treatment thoroughly. Unlike the useless Spire doc. So I would phone up a few doctor's to see how they would do it. I would not recommend Spire at all.

Spire is my local! That's where I was looking. Not sure where else local would do it but I can have a look. I've used our local Spire before for other things in the past and they were great, and I have a friend who is a regular there for something else and also had a good experience. Probs depends on the hospital and speciality involved too. What is tretinoin?

Yes, I'm sure some are good. Even the receptionists at this one were appalling. Very snooty and ignored DD. One time I tried to phone to cancel an appointment 7 times. When I got through they said they were understaffed that day!
Tretinoin is a topical treatment. Google topical treatments for acne. Many can be prescribed online.

I was prescribed roaccutane via the NHS nearly 20 years ago after suffering with acne for years throughout my teens. My skin was excellent once the treatment kicked in! It did take about 8 years to get taken seriously before I saw a derm.

As an approaching 40 year old with some fine lines and acne scarring I'm now using ritirides which I bought in Spain and is a topical retinoid in the hope that it will improve my skin texture and appearance.

I'm in the unfortunate situation of having quite a bit of scarring and am considering paying for some laser treatment to remove it.

If I had my time again (and will certainly do this with my daughter if she suffers) will go the private dermatology route ASAP as I'm sure it's cheaper (and less invasive) than having to consider multiple treatments to remove the scarring. There is certainly no NHS finds available to help with that!

Just another way of thinking......

I get that logic, really I do. But if I don't have the money, I don't have the money, there's nothing I can do about that. We are a low income family propped up by the benefits system. GP has prescribed me Epiduo which I have been using for a couple of weeks and am starting to see some slight improvement I think altho difficult to know if it's just coincidence yet or not. I was also prescribed my old COCP but the pharmacy didn't have any and have since found out it's been discontinued. So need to call them to ask them to switch me onto a different brand. I know Dianette is popular for acne but I'm loathe to go straight to the higher dosage of oestregen for fear of side effects especially as my old pill was only 20mg oestregen and I get migraines.

This is a bit sneaky but I had a private initial consultation and then got an apt on the consultants NHS list for all the remaining treatment.

I liked into private roaccutane as NHS derms didn't consider my acne bad enough. It wasn't but I'd had enough still having extra oily skin and spots on my face, chest and back.

The private dern did refer me to an NHS dern though who prescribed spironolactone for me. Worked a treat.

Stick k with the epiduo. I found it effective and still use it a couple of times per week.

Re the combined pill diannette is excellent. I took it for years. I hear Yaz works well for skin too.

I've just finished a course of 20 weeks which I paid for privately. I've suffered with persistent acne for over 10 years after coming off the pill.

I was referred via my GP as I had little or no hope of getting this prescribed via an NHS dermatologist and would have had to wait in excess of one year for an appointment with no guarantee it would get prescribed.

I'd tried every cream, gel and antibiotic from my GP with no success.

The figures below were the actual costs

£180 for every 4 week consultation.

Private prescription for the isotretinoin £70 every four weeks.

Pregnancy Test, bought by myself and had to be done four weekly for each consultants visit.

Blood tests, every four weeks, done via my GP at no cost to me.

Although I've only recently stopped taking the medication I've never had a period of being spot free like this in my life.

I'm still not yet producing any oil although it will likely return but at a reduced level.

I am so so happy with how my skin is currently and I still only have to wash my hair once a week, without it ever looking greasy.

It's the best thing I've ever done for my skin.

I wish you all the best in your journey. 💐

@MeadowHay just wondered what you decided in the end? Are you waiting for the NHS appointment? I've just had a private appointment for my DD who is 14. I got an appointment the next evening and picked up medication the day after that, easy! It cost £150 and then £118 for the isotretinoin. That will be it. No more appointments unless we request one and given 4 months dose he said that should be enough. Derm said he trusts patients that present fit and well and won't put her through a blood test etc, so just wanted to say it may be worth you ringing round a few as they seem to differ slightly. It was much easier than I thought it would be and he was so confident it will work. DD is thrilled. I understand you're worried about scarring which is why I worked some overtime to fund this privately! Hope you find the solution that works for you, acne sucks.

@MeadowHay which dermatologist did you go to? I can’t afford to go many times but I know I need Roaccutane after trying various things for ten years and gp refusing to refer me back to my previous nhs dermatologist without trying everything again

@tararob have a look at Dermatica - it’s an online subscription dermatologist that have prescription strength treatments. They treat acne.

I really rate them, it’s £20 a month and I use Tret/niacinamide (anti aging is my biggest worry) but it’s a good way to get products that will work, without paying hundreds.

@TeddyIsaHe Isotretonoin is a tablet, You’re thinking of tretonoin which is the topical version.

I’m 95% sure Meadowhay had the tablets on the nhs.

I took it for 4 months on the nhs and haven’t needed a second course or had any more problems with my skin.

@tararob. That’s made me so cross reading that, can you see a different dr at your practice?. cks.nice.org.uk/acne-vulgaris There’s nothing in the nice guidelines to say “try everything, then repeat when it’s failed”.

They are very clear on when to refer to Dermatology.

@Fluffycloudland77 cos of quarantine I’ve had to speak to one on the phone who didn’t listen and insisted I try yazmin (the pill for acne) even tho I specifically said I’ve tried two pills and antibiotics for my acne before Years ago (dianette and combined) and they didn’t help much plus I didn’t want to be on contraception long term it just masks the issue of acne untill you come off it, makes you feel sick etc. Don’t want to mess around with my hormones anymore.
I then requested I speak to a different gp on the phone and they ended up just telling the receptionist to phone me back and tell me the same thing the previous gp told me even tho I was crying on the phone the first time.
Basically because I haven’t been to the dermatologist in two years I have to try pills creams and antibiotics again even tho last time I went they actually offered me Roaccutane but I didn’t want it at the time. It’s like why now can’t I change my mind if I previously could’ve had it and my acne is just as bad. Apparently there’s a process you have to do each time you want a referreral they said phone back after being on the pill for six month ignoring the face I don’t want to be on the pill and I can’t cope another six months before even starting the referral process.
I’m thinking of changing surgeries and insisting on a face to face as my scarring is what they need to see really

If your scarring that’s really serious. Not all drs surgeries are created equally unfortunately but you can see reviews online now which is helpful.

It makes me so cross that people get fobbed off but when you actually see dermatology their like “yep here you go see you next month”.

I was offered accutane at 30, turned it down. Limped on till 41 then took it willingly.