Buying health services for local people

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Acne – Information for GPs

Referral Criteria/Commissioning Postition

Refer to specialist services such as GPwSI in dermatology or to secondary care for:

  • are at risk of, or are developing, scarring despite primary care therapies
  • have moderate acne that has failed to respond to treatment which should generally include several courses of both topical and systemic treatment over
    a period of at least 6 months
  • a very severe variant such as fulminating acne with systemic symptoms (acne fulminans) or gram negative folliculate
  • severe acne or painful, deep nodules or cysts (nodulocystic acne) and could benefit from oral isotretinoin
  • severe social or psychological, including a morbid fear of deformity (dysmorphophobia)
  • are suspected of having an underlying endocrinological cause for the acne(such as polycystic ovary syndrome) that needs assessment

Cosmetic treatment for scarring is not routinely commissioned.

All requests for funding need to be made via the Individual Funding Request (IFR)

Investigations prior to referral

  • FBC, U/E, LFT, fasting cholesterol and triglycerides
  • Organise contraception in all sexually active females (or those likely to become so shortly) before referral if oral isotretinoin may be considered. Can be combined with any oral contraceptive

Information to include in referal letter

The GP referral letter should contain:

  • Details of how the patient meets the criteria
  • Treatments and interventions, current & past tried including the results,
  • Drug history (prescribed and non-prescribed)
  • Relevant past medical/surgical history
  • Current regular medication
  • BMI
  • Smoking status
  • Alcohol consumption
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