Isotretinoin
Understand whether isotretinoin is the right next step.
A comprehensive evaluation for patients considering isotretinoin. The visit focuses on candidacy, reasonable alternatives, monitoring requirements, and what long-term treatment actually looks like.
Who it's for
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
Commonly evaluated
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
The visit
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
Treatment categories
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
Included
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.
FAQ
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.