Private derm for roaccutane for teenager?

[JoanDarc]

Interested to hear of any experiences and costs for going private for roaccutane treatment? My daughter is 13 yrs and has had acne for 2 years, topicals making little difference, in fact her skin is getting worse with more coverage with some scarring.
We’re due back at GP to revisit her treatment, currently on adapalene and think next course may be antibiotics.
I had a similar journey with my skin and wish I’d been prescribed roaccutane sooner than my thirties. It was the only thing that worked.
I’m sure I’d read on here years ago about going private for initial appointment then re- referred into NHS to continue treatment so any knowledge or experience very welcome.

My experience is a while ago now, but I would ask for a GP NHS referral asap.

I found that even under the dermatologist at my local hospital, they wouldn't prescribe roaccutane, I had to be referred onto a specialist centre (Leeds I think).

The trouble with going private is that it's not just the appointment, but also the regular tests, prescription costs etc - you may not get a transfer back to NHS as quickly as you'd like.

Hope you manage to get something sorted.

Around here the private dermatologists follow the same guidelines as the nhs ones so oral antibiotics and the contraceptive pill would be tried before roaccutane . The time on each trial can be sped up if the young person is scarring.

Thanks both for responses. I’m pre empting a long referral wait when GP finally can refer on after options been explored.

They won’t prescribe until you’ve tried oral antibiotics. It’s a last resort drug.

I took it but I had to have tried everything else.

I’ve just tried this for DS. I phoned around and found the ones in my area wouldn’t take on an under 18. One did give me the details of a paediatric derm.
Go back to your GP and ask for a referral to a paediatric derm &/ private referral. Acne and the scarring can be debilitating for kids.

I tried everything topical and antibiotics as a teenager, and nothing had any impact at all. Then I tried the pill, which was amazing, and cleared it up really well, as well as sorting out painful periods. I wish I had taken it years sooner, and avoided a lot of scarring.

Dd was prescribed it on the NHS when she was 15.

We've just done it for my son (15) and the derm said she wished we'd gone earlier. £270 per consult (we've had 3). £320 for all the meds per 3 months (we're on our 3rd and last set 🤞). He had roaccutane plus various creams. We had one blood test at the beginning via our GP so that was free. It's made his skin much much much better. No possibility to refer back to the NHS though and she was very clear about that at first appt. Happy to answer any questions.

If you can afford it, absolutely do it.

Thanks @YouBetYourBippy that’s really helpful info. Had your son had to complete other treatments before being considered by the derm? I’m not thrilled about long term antibiotics for my daughter which I think is the next course of treatment.

@JoanDarc So he had had a 6 month course of antibiotics and some topical treatment via the GP before we decided to go private. I suspect that if we had gone to this derm earlier though and with the degree of acne he had she might have put him straight on roaccutane. She is very big on avoiding scarring - and she says she prefers to see them earlier as she can normally use shorter courses of treatments. If you're in South London I can DM you her details - I'd really highly recommend her.

My DD15 was hugely anxious due to acne and didn't want to be seen.

She completed a 12 week course of antibiotics and there was a huge change in the last two weeks.

I would be wary of Ruaccutane because of the mental side effect.

Just be aware there has been a big national safety update on isotretinoin about 2 weeks ago - https://www.gov.uk/drug-safety-update/isotretinoin-roaccutanev-new-safety-measures-to-be-introduced-in-the-coming-months-including-additional-oversight-on-initiation-of-treatment-for-patients-under-18-years
Now two separate dermatologists have to agree (and sign) if under 18 that acne is severe enough to warrant treatment and standard treatments have been sufficiently tried (this affects private sector too); it is very likely that prescription of isotretinoin in young people will tighten as a result
Also, in the days gone by consultants would see once privately and move to nhs straight away to continue treatment - this rarely happens these days (I’m sure it happens a bit but it is not the norm) as people are a lot more careful regarding ethical practice
Definitely give antibiotics in combination with a good topical (could try Treclin) a try first - it could work very well for her.

Pill an option also - Yasmin and Dianette good for skin

My 14 year old has just finished an 8 month course of roacutane. We did have to go private as NHS waiting times for referral were too long.

prior to roacutane, child had been on all topicals and 3 months of antibiotics. Dermatologist evaluated that child’s type of acne was unlikely to respond well enough to antibiotics.

Private derm through a private hospital who was fantastic. After initial consultation, blood tests and pregnancy test, monthly prescriptions were given. Pregnancy tests needed to be done monthly. Dosage was started very low to prevent dramatic purging and side effects. Dosage was monitored very closely each month for mental health side effects. I was told how to drop the dosage in between monthly consultations if I noticed any adverse effects or mood changes. Was worth every penny and the care was fantastic.

Initial consultation was £250, follow ups were £150. Pregnancy test from pharmacy. Prescription was around £50ish depending on pharmacy (often had to phone around to fill prescription). Can’t recall how much blood tests were sorry.

My DC had 12 months of roacutane he had the maximum dosage for his weight and height, It knocked it flat in a month and completely healed his skin.

We had a mental health meeting each month it cost over £1k but the result was amazing all though Spire

Thanks everyone for your input.
@Harryateacroissant that’s really useful info, thank you. I’m assuming you work in a related field? Interested in your thoughts as I tried lymecycline (sp) and it didn’t make much of a difference to me but understand there are more options available now. I was also on Dianette for years in my teenage years to twenties and was under the impression it wasn’t prescribed anymore?
For both antibiotics and oral contraceptives is the issue that the acne will return once the medication is stopped whereas roaccutane it almost resets the skin? Unsure if this is just my experience.
@mauveiscurious @Howtofixthis so pleased to hear your children have had a positive experience on it.

The consultation says as along as they have their weight quota it switches off the sebaceous gland over production which causes acne.

It worked so quickly and changed their life and probably future outcomes for mental health

I agree the care and dosage was amazing. Our GP was very supportive and instructed the blood tests through the NHS for us too

Gosh, this is a tricky one. I hadn't realized it would be so difficult to get prescribed Roaccutane privately.

I had it on the NHS at 18, but that was after YEARS of other medications including several frustrating years at Hammersmith hospital being prescribed various antibiotics. Also took Dianette which worked fairly well but made me seriously depressed.

Perhaps depression was looming anyway in my DNA, but I've often wondered if it was caused by taking this pill for acne at 16. The bigger problem, and you're absolutely right to be cautious, was the four YEARS of antibiotics. I don't think that in the 90s people spoke much about gut bacteria, but the antibiotics absolutely trashed mine. I had serious stomach pain frequently during the years I was taking them and have had various digestive problems since then including a stomach ulcer in my 20s.

FWIW the Roaccutane cleared my skin up permanently in about two months. Ironically, in my 20s people often told me what great skin I had. (I was lucky to have no visible scarring, only hyperpigmentation. As I've got older and wrinklier I can see that I do in fact have some scarring, but it wasn't visible when plumper and dewier of face. Maybe there is some more careful test they can do for this.)

If you can, get the Roaccutane. It's great that you're taking it seriously. Acne also trashed my social life and self-confidence as a teenager. (It might have improved my GCSE results.)

Just make sure you are fully aware of the side effects.

My brother and cousin were both prescribed Roaccutane in the 80s.

My brother has struggled with depression his entire adult life, which the doctor put down to the Roaccutane. My cousin suffered with hair loss and infertility, again put down to the Roaccutane.

It really is a last resort drug.

This wasn't the case for me.
Granted I had exhausted most of the other medication routes from the GP but when I had my referral, first appointment with dermatologist we talked through everything. Organised a pregnancy test and blood test, then I had my prescription. I can't remember how long I was on it but it cleared my skin in a matter of months. The side effects weren't too horrific but I did have incredibly chapped lips and sensitive skin.

Some years on I've never had any acne outbreaks since and rarely (maybe once every few months) get a single spot.

Minimal scarring.

Go for it OP. I hadn't tried the contraceptive pill and didn't want to. I had no problem getting the prescription.

I also didn't have any antibiotics OP.
Just lots of tablet and ointment medications before from the GP.

No pills or antibiotics.

OP dianette, (also under other names) is still prescribed but you could also try Yasmin.

I would definitely try this before roaccutane which for me would be a last resort.

A derm could also prescribe spirolactone (so?) but again I’d go Yasmin/Diane before that.

Try lymocycline first.

I had very spotty teenagers and one was on roaccutane ( brilliant! Would pay for it again in a minute) The other had good results with lymocycline.

If it hadn't worked then I'd have paid for roacctuane for them too.

13 seems very young to have severe acne. My kids were older.