Acne treatment with Isotretinoin (Roaccutane) Dermatologist2020-06-12T15:04:51+00:00

Feel in charge of your skin


We have little control over the current situation, but one thing we can have control over is our skin


In the videos above, I explain acne treatment in a simple way. Of course, no video or website can replace the value of a personalised consultation. At your consultation, I can carefully examine your skin and give you an expert recommendation to help you resolve your skin condition.

Treatment enables people of all ages take control of their skin condition and get their life back

9 times out of 10, isotretinoin clears acne


What’s the most effective treatment for acne?

Isotretinoin (also known as Roaccutane) is by far the most effective treatment for severe, persistent or scarring acne to date. We can use it effectively on both teenagers and adults, provided there are no reasons to the contrary.

Who responds well to isotretinoin?

If you have acne that has resulted in scarring or has not responded to other treatments, then isotretinoin might be for you.

How can you get assessed for treatment?

If acne affects you or your child, if either of you have struggled to get your acne under control, or if you’re concerned about possible scarring, then you may want to visit with me for a acne treatment consultation. Once I have seen you, and if I recommend treatment with Isotretinoin, you can rest assured I have weighed the risks and benefits of treatment and ruled out any possible contraindications before proposing this treatment.

Does any of this ring a bell?

You may also find yourself lacking in confidence or feeling quite self-conscious and sometimes low about your skin. It may be that your child’s skin is having a significant impact on their confidence. Often my patients tell me that they are reluctant to leave the house or that they are intentionally limiting their social activities because they are worried about what people will think of their skin.

What can you expect after treatment?

Isotretinoin is thought to clear acne in up to 90% of people who take it, so we can be quite optimistic that your skin will clear once you complete your treatment. It can take some time for marks caused by previous acne spots to fade.

What my patients love about my service


Please pass on my thanks to Dr Pratsou for her assessment on my continued taking of roaccutane.

She was completely right, I didn’t need a new course, I needed to move away from the drug. The creams she gave me and Cetaphil recommendation have meant my skin has been the best it’s ever been (ongoing and since I saw her) ALL SUMMER :))))) I’ve had zero problems…and I’m loving it.

Thank you once again.

Phillip, Acne

“Dear Dr Pratsou,

Following the consultation today I feel it appropriate to say thank you for your help in dealing with my rosacea.

On each occasion, I have visited your department I have noticed the kindness and cheeriness of all the staff I have encountered and particularly wanted to say that you made me feel at ease with your calmness and excellent manner.

All is much appreciated.”

Anne, Rosacea

“Thank you very much!!

You three were (and are) a great team!

I will remember you.

You made me feel comfortable.”



Please pass to Dr Pratsou my thanks for her skilled work.

The wound is healing beautifully and now the stitches are out it looks as though it will be almost invisible once fully healed.”

Graham, Skin cancer removal

“Dear Dr Penelope, Rena & the team, (I can’t remember the nurse’s name who helped me during my 2 procedures at the Spire!)

I wanted to thank you for your support and help during a very difficult time. You guys do a wonderful job – and we are eternally grateful for your help.”

Clarissa, Skin cancer

“I would like to put on record how impressed I was with the operation you performed for the removal of the SCC on my neck. I cannot even see where the cut or the stitches were! I am indeed very grateful for the excellent work you do.”

Harry, Squamous Cell Carcinoma

“Dear Dr Pratsou,

I am very grateful to you for your diagnosis, recommended treatment and advice. Your letter to my GP sets out both the course of events, and your own analysis of probable condition and possible cause, clearly summarising our discussion.

I hope there will be no recurrence but I will certainly come back to you if there is.”

Ryan, Skin rash

“Dear Tania,

Please pass on my thanks to Dr Pratsou. I saw her this morning for a mole check. She was so lovely and reassuring. Please also thank the two nurses who assisted her during the mole removal procedure. I was very nervous, but they were very efficient, which meant I did not have too long to think about it, but most of all they were very kind. They kept me distracted and calm, which made a huge difference. Thank you also for your efficiency in both booking me in so quickly.”

James, Mole removal
Dear Ms. Pratsou,

I am writing to thank you for the care you have given me in the past few months. From the moment I walked into your consulting room with a lesion on my cheek, a lesion that I fully expected to be some sort of skin cancer (and it was), you have been thorough, reassuring, respectful and in every way professional.

You recognised that I had some insight into the condition of my skin and the procedures required to treat me. You listened to me. You projected expertise and compassion.

During the procedure to remove the growth you ensured that the atmosphere in the treatment room remained not only calm, but actually pleasant. Had it not been that you were excising a growth and sewing me up, I almost felt as if you, me and the nurse were at some sort of women’s discussion group. The time flew by. I had zero anxieties about the procedure and as we both know now, the wound healed flawlessly.

Thank you for your expertise and your communication skills and all round good nature. I feel very lucky.

Karen Tatom, Skin cancer removal

We have replaced the images and names of real patients who provided these testimonials to protect their privacy.

Take this quick quiz to find out IMMEDIATELY if your acne is treatable

How it works



Give us a call on 01183735198 and we’ll help guide you towards a first appointment.


I’ll see you and examine your skin before I recommend treatment. In some cases, I can begin treating your condition on the same day.


I’ll guide you down the road towards a resolution of your skin condition so that you can get back to normal life.

More information about acne treatment


Isotretinoin (Roaccutane) is an oral retinoid which I use to treat severe or resistant types of acne.

This method is by far the most effective acne treatment to date and can be used in both teenagers and adults.

  • Severe nodulocystic acne
  • Acne resulting in scarring
  • Acne that has not responded to other treatments
  • Acne that has persisted beyond the age of 30
  • Acne causing significant psychosocial morbidity
  • Severe rosacea
  • Follicular occlusion disorders, for example, hidradenitis suppurativa and certain inflammatory scalp conditions

You may be reading this page because acne affects you or your child.

You may have struggled with getting your acne under control having tried many topical preparations and antibiotics by mouth.

Alternatively, you may be concerned about possible acne scarring and wish to prevent it from progressing.

You may also find yourself lacking in confidence or feeling quite self-conscious and sometimes low about your skin.

It may be that your child’s skin is having a significant impact on their confidence.

Often my patients tell me that they are reluctant to leave the house or that they are intentionally limiting their social activities because they are worried about what people will think of their skin.

If any of these ring a bell then you wish to consider acne treatment with Isotretinoin (Roaccutane).

Other considerations that may determine how suitable this treatment is for you or your child, include any pre-existing health problems. We can determine these during your initial consultation.

Isotretinoin, otherwise known by the brand name of Roaccutane, is an oral retinoid that targets acne in many ways to cure it.

It is thought to clear acne in 9/10 cases. A small proportion of patients may relapse at a future date. They may require a second or prolonged course of Isotretinoin before entirely clearing.

A course of treatment generally lasts around five months, but we may need to be prolong it by a few months in cases where the skin has not fully cleared or where we have used lower doses.

It is essential that you take Isotretinoin regularly as I prescribe (that is, usually once a day with a meal or a glass of milk as fat enhances its absorption).

I counsel any patient considering Isotretinoin therapy on its benefits, risks and contraindications. The most frequent side effects with treatment consist of dryness of the lips, facial skin and mucosal surfaces (for example, the nose and eyes). You can counteract these side effects with proper amounts of lip balm and moisturisers.

Isotretinoin can make you more sensitive to sunlight. Therefore, you should take adequate sun protection measures during the course of treatment.

Muscle and joint aches can occur depending on your level of physical activity, but patients usually tolerate these without problems.

Rarely there is a potential for Isotretinoin to cause liver inflammation. Therefore, I carefully monitor the liver with regular blood tests. It’s also best that you completely avoid alcohol during the course of treatment.

We can see cholesterol and triglyceride levels rise during treatment. Generally, the rise is temporary (that is, only during the course of treatment). We carefully monitor this indicator, and it usually returns to normal once you discontinue treatment.

Importantly, because Isotretinoin is an oral retinoid, it is known to be teratogenic. That means that it can potentially harm a foetus during pregnancy. Therefore, I counsel all women of childbearing age taking Isotretinoin about the need for contraception, during and one month after their Isotretinoin treatment. In exceptional circumstances, women may be allowed to opt out of the pregnancy prevention programme plan at my discretion. I will however always require you to take a monthly pregnancy test before I issue each prescription.

Uncommonly, there can be a potential for mood problems including low mood and heightened anxiety in patients taking Isotretinoin. In the past, there have been reports of suicidal ideation and even suicide attempts. These would be exceedingly uncommon, but careful selection of patients reduces this risk. You should report any changes in mood during treatment to me immediately.

Can Isotretinoin affect my future fertility?

No, Isotretinoin should not affect your future fertility. If you are a woman of childbearing age, you are advised strongly to use at least one and preferably two methods of reliable contraception while on Isotretinoin treatment and for one month after that. That is because Isotretinoin carries the risk of teratogenicity. However, it should clear your system within five weeks of stopping the treatment and should therefore not affect your future fertility.

Are there any other special precautions that I should avoid during treatment?

Your skin may feel particularly sensitive during and for a few months after treatment. It would help if you, therefore, avoided potentially irritant treatments such as microdermabrasion, epilation, waxing and laser treatments during treatment and for 6-12 months afterwards.

I am worried about all the potential side effects with Isotretinoin. Would you really recommend taking this drug?

Embarking on Isotretinoin therapy can often be a daunting prospect. There are potential side effects, but the rewards are also high.

Once I have seen you, and if I recommend treatment with Isotretinoin, you can rest assured that I have weighed the risks and benefits of treatment and ruled out any possible contraindications before proposing this treatment.

Of course, anyone taking this treatment needs to ensure that they are happy to go ahead. It would be best if you carefully read the patient information leaflet provided and weigh up the pros and cons.

I tend to see patients on Isotretinoin therapy on a monthly basis to ensure that treatment is going as expected and to make any tweaks that we may need to along the way.

Will Isotretinoin therapy help with my acne scarring?

The principal way in which Isotretinoin will help with your acne scarring is to prevent further scarring from developing. That is by far the most crucial intervention in patients who tend to scar.

Treatment of acne scarring varies in its effect, and should only be considered 6-12 months after discontinuing Isotretinoin therapy.

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Questions and answers


About the author

Dr Penelope Pratsou | Consultant Dermatologist

MBChB, MRCP (UK) (Dermatology)

I’m Dr Penelope Pratsou, a skilled independent Consultant Dermatologist based in Berkshire. I have specialist expertise in the diagnosis and management of all skin cancers, and in performing mole checks. I’m a trained skin surgeon and remove skin cancers, moles, skin tags, cysts and warts.

I also have invaluable experience in dealing with all skin conditions, from the common skin complaints of acne, rosacea, eczema and psoriasis, to the rarer and more complex skin problems, having seen it all through years of NHS work.

After I obtained my Membership to the Royal College of Physicians, I undertook rigorous specialist training in dermatology, before being appointed as a Consultant Dermatologist at the Royal Berkshire Hospital, Reading. There, I helped set up and lead a busy clinic for the diagnosis and treatment of suspected skin cancer. I was also actively involved in supervising and training both dermatology and GP trainees.

Alongside my increasingly busy private practice, I have maintained an NHS practice in Oxford in order to continue to engage with challenging cases and to develop my specialist interest in skin allergy.