Consultation

Have you been diagnosed with acne by a healthcare professional before?

Are you aware you should NOT USE more than one topical treatment for acne at the same time?

• Zineryt – antibiotic
• Differin – retinoid
• Epiduo – anti-inflammatory with retinoid
• Duac – antibiotic with peeling agent (benzoyl peroxide)

Are you aware Lymecycline antibiotic capsules should not be taken whilst using Zineryt or Duac (topical antibiotics)?

Lymecycline can be taken whilst using Differin and Epiduo.

Are you aware Lymecycline capsules are best used with topical Differin, Epiduo, or over-the-counter benzoyl peroxide at the same time?

This reduces the chance of antibiotic resistance.

Are you aware that antibiotic treatments – Lymecycline, Zineryt, Duac – should not normally be used continuously for more than 3 months?

If used for longer there is an increased risk of antibiotic resistance.

Are you aware it usually takes 8 weeks or more of continuous usage for treatments to work?

If there is no improvement after 4 months, treatment should be stopped or changed.

Are you aware, if acne has cleared up, treatment should be stopped or reduced after 4 to 6 months?

Are you aware you should see your GP if acne is scarring or getting worse?

Are you allergic to any of the below treatments?

• Zineryt (erythromycin),
• Differin (adapalene),
• Epiduo (adapalene with benzoyl peroxide),
• Duac (clindamycin with benzoyl peroxide),
• Lymecycline (tetracycline).

Are you aware the following treatments should NOT be used if you are pregnant or breastfeeding?

• Differin
• Epiduo
• Lymecycline

Are you aware topical treatments containing retinoids and peeling agents (Differin, Epiduo, and Duac) can cause irritation?

Irritation can be reduced by starting treatment on alternate days and building up to the prescribed dose as tolerated.

Are you ordering Lymecycline and been diagnosed with liver or kidney disease?

Do you have any further questions you need help with before deciding on a treatment?

Do the following apply to you?

• The treatment is for my own use
• I will read the patient information leaflet supplied with the medication
• I am over 18 and I agree to identity verification checks
• I have completed this questionnaire myself and fully understand all the information
• My responses are honest and accurate, and I understand that this is necessary for a safe medical assessment
• I agree to the terms & conditions, privacy policy, & data sharing policy

What is the name of your GP surgery and do you consent to us contacting them about your treatment?

Do you consent to us accessing your GP records? This is advised so we can clinically assess suitability.