Online dermatologist for isotretinoin evaluation.
A comprehensive evaluation for patients considering isotretinoin. The visit focuses on candidacy, reasonable alternatives, monitoring requirements, and what long-term treatment actually looks like.
Medically reviewed by Gibran Shaikh, MD, FAAD· Last reviewed September 2026
Board-certified dermatologist · Clinical Instructor, Dermatology, Mount Sinai
4.76/5 from 500+ patient reviews on Zocdoc
Who this consultation is for
- Patients considering isotretinoin for the first time
- Prior isotretinoin courses with incomplete or unclear results
- Patients seeking a second opinion on candidacy
- Anyone who wants to understand risks, monitoring, and alternatives in detail
Symptoms and situations
- Severe, scarring, or nodulocystic acne
- Persistent acne despite oral antibiotics or hormonal therapy
- Recurring acne after previous treatment courses
- Significant psychosocial impact of acne
What Dr. Shaikh will review
- Prior topical, oral, and hormonal acne treatments
- Medical history, medications, and relevant laboratory results
- iPLEDGE requirements and monthly monitoring expectations
- Pregnancy-prevention requirements where applicable
- Alternatives to isotretinoin appropriate to your presentation
- Expected duration of therapy and follow-up plan
Potential treatment categories
Treatment is individualized. Categories below may be discussed when clinically appropriate. No prescription or specific outcome is guaranteed.
- Assessment of candidacy and treatment goals
- Discussion of alternatives when isotretinoin is not the right fit
- Overview of iPLEDGE enrollment and monthly requirements
- Overview of laboratory monitoring during treatment
- Follow-up planning for ongoing management
When video care may not be appropriate
Some presentations require in-person examination, dermoscopy, biopsy, procedures, or urgent evaluation. If video care is not appropriate, Dr. Shaikh will explain when in-person evaluation is recommended.
- Acute severe reactions requiring urgent in-person care
- Patients unable to complete required laboratory monitoring
- Situations where in-person examination is required before prescribing
What the $250 visit includes
A comprehensive live video consultation with Dr. Shaikh — not an asynchronous topical pathway.
- A 30-minute live video visit directly with Dr. Shaikh
- Review of your acne history and prior treatments
- Honest assessment of whether isotretinoin is a reasonable next step
- Written summary of the plan, including any next steps required before prescribing
Medication, laboratory testing, and follow-up visits are not included unless explicitly stated.
Common questions
- Will I be prescribed isotretinoin at the first visit?
- No. The first visit is an evaluation. Isotretinoin requires enrollment in the iPLEDGE REMS program, laboratory testing, and, where applicable, pregnancy-prevention requirements. Prescribing is only considered when it is clinically appropriate and all program requirements are met.
- What is iPLEDGE?
- iPLEDGE is the FDA-mandated Risk Evaluation and Mitigation Strategy program required for anyone prescribed isotretinoin. Enrollment, monthly monitoring, and ongoing compliance are required throughout treatment.
- What alternatives to isotretinoin might be discussed?
- Depending on your acne pattern and history, alternatives may include oral antibiotics, hormonal therapy such as spironolactone, or optimized topical combinations.
- How often are follow-ups required?
- Isotretinoin treatment requires monthly follow-up visits and laboratory monitoring for the duration of therapy. These are billed separately from the initial consultation.
Online dermatology available in 13 states
Eligibility follows the state you are physically located in on the day of the appointment, not your mailing address. See where care is available by state — including New York, Florida, Texas, Illinois and Arizona.
Reviewed by a board-certified dermatologist
This page was written and medically reviewed by Gibran Shaikh, MD, FAAD. Board-certified dermatologist · Fellow of the American Academy of Dermatology. Last reviewed September 2026. This information is educational and does not replace an individual consultation, diagnosis, or treatment plan.