Beacon Trial – Best systemic treatments for adults with atopic eczema over the long term

South West Dermatology have been asked to highlight to potential patients with moderate to severe eczema a clinical trial comparing the advantages and disadvantages of the current second line treatment options where traditional topical treatment has failed. This is a national UK clinical trial and being hosted by the Royal Devon & Exeter NHS Trust hospital.

This trial is open to adults 18 years and over only with moderate to severe eczema not responding to prescription eczema treatments. 

There are inclusion and exclusion criteria that would need to considered by a consultant Dermatologist before agreement that a potential patient is eligible to participate.

Potential patients would need to be agree to be reviewed and monitored at the Exeter hospital as per the clinical trial protocol.

Potential patients agreeing to be considered for the  trial would have the advantage of accessing NHS Dermatology at the hospital sooner than the current routine wait following referral.

Find out more information by visiting the Beacon Trial website.

Please note we can only refer potential patients that we have seen face to face to this clinical trial. Do not automatically assume we will refer you on on for this clinical trial simply because you request it, or believe you are eligible or because you have booked a consultation with us. There are inclusion and exclusion criteria that a Dermatologist needs to assess without prejudice.

Oral Ritecitinib is a JAK3/TEK kinase inhibitor and was NICE approved for severe alopecia areata in February 2024 for adults and children over 12 years old.

It is the only approved licence medication for this condition.

Alopecia areata is an autoimmune condition that in most case causes mild patchy hair loss that comes and goes. When it is more extensive and widespread it often does not respond to traditional simple treatments such as topical preparations or low strength steroid injections. Up until now, a safe effective treatment for severe and unresponsive cases has not been available..

Oral Ritlecitinib is taken daily at a dose of 50mg a day. A loading dose of 200mg is recommended but not necessary. Hair recovery can take a few months to be seen and continues to improve with long-term use. Patients would be expected to stay on this medication long-term over many years. Common side-effects are headaches, an increased chance of coughs and colds and acne. Patients are recommended to have a Full Blood Count blood test before starting treatment and four weeks into treatment.

There are many different treatable types of hair loss that we routinely manage as Dermatology experts. More information on different types of alopecia/hair loss and this medication can be found on alopecia.org.uk

This medication cost approximately £400 per month privately (excluding consultations and any investigations required).

Following the Valisure report that found the chemical benzene in acne products containing benzoyl peroxide South West Dermatology are providing information to our past, present and future patients of topical Benzoyl peroxide.

Benzoyl peroxide is a common acne-fighting ingredient available by prescription and over the counter, which has the potential to break down into benzene. In March 2024, a petition was filed with the U.S. Food and Drug Administration (FDA). This petition expresses concerns that benzene, a cancer-causing substance, may be found in acne products containing benzoyl peroxide when these products are exposed to higher temperatures.

No petition has currently been raised in the UK or EU as of March 2024, but this position may change.

Most consumers do not store personal care products in the conditions in which Valisure tested the products. More information is needed to know if/how benzoyl peroxide may degrade into benzene at room temperature. Benzoyl peroxide has been a key acne-fighting ingredient used for many years. While there are no direct alternatives to benzoyl peroxide, your dermatologist can help you find other options if you are uncomfortable using benzoyl peroxide in your acne regimen as we learn more.

Other over the counter or prescription only treatment options include topical adapalene, salicylic acid, or azelaic acid.

Benzene found in Acne care products

Frequently asked questions

What is benzene — and what makes it a human carcinogen?

Benzene is a colourless, highly flammable chemical that is used widely to make products, including drugs, detergents, dyes, plastics and lubricants. It is also found naturally in car fuel and cigarette smoke. Benzene can cause cells not to work correctly, and the seriousness depends on the amount, route, and length of time of exposure, as well as the age and pre-existing medical condition of the exposed person.

Benzoyl peroxide is a common active ingredient in acne-fighting personal care products and some prescription items. Benzene is not intended to be included in these products. In some personal care products contaminated with benzene, benzene is introduced during manufacturing. In the case of products with benzoyl peroxide as an active ingredient, the benzoyl peroxide can break down, which introduces benzene into the product.

What products were found to contain benzene?

Valisure’s research was performed on dozens of over-the counter benzoyl peroxide products. However, little information is provided about which products had benzene detected at baseline (and how much).

How can patients continue treating their acne while avoiding this contaminant?

There are many ingredients that help fight and prevent acne. If your current treatment plan includes benzoyl peroxide and you would like to avoid this ingredient, consult your Dermatologist or GP for alternate options.

How should I care for my skin if I have acne?

We recommend the following to care for your skin during acne treatment:

  • Keep your skin clean. Gently wash your face up to twice daily and after sweating. Choose a gentle, non-abrasive cleanser. Apply it with your fingertips, as scrubbing with washcloths, sponges, and other tools can irritate your skin.
  • Choose the right skin care. Use gentle skin care products and ones that say “alcohol-free” on the label. Avoid products that can irritate your skin, including astringents, toners, and exfoliants. These products can dry your skin and make acne appear worse.
  • Shampoo regularly. The oil from your hair can cause acne on your forehead. If you have oily hair, shampoo more often than you do now and keep your hair away from your face.
  • Keep your hands off. Touching your face throughout the day can cause acne to flare. While it can be tempting to pick, pop, or squeeze your acne, doing so will make the acne take longer to clear and increase your risk for scarring and dark spots called post-inflammatory hyperpigmentation.
  • Stay out of the sun and tanning beds. Along with increasing your risk for skin cancer, tanning damages your skin and can worsen acne. Some acne medications can also make your skin very sensitive to damaging ultraviolet rays from the sun and tanning beds.
  • Protect your skin by avoiding tanning — indoors and out — and by seeking shade, wearing sun-protective clothing, and applying a broad-spectrum, water-resistant sunscreen with an SPF of 30 or higher to all skin not covered by clothing when outdoors. Look for a sunscreen that says “non-comedogenic” or “won’t clog pores.” For more effective protection, select clothing with an ultraviolet protection factor (or UPF) number on the label.

What else should I consider?

If you are concerned about ingredients in your acne skin care and medications, talk to a registered Consultant Dermatologist to develop an acne treatment plan that works for you.

Call Sarah on 01392 350059 if you have any concerns or would like to see Consultant Dermatologist Dr. Anthony Downs or Dr. Chris Bower to discuss further.

Dr Tony Downs is a member of the British Association of Dermatologists, European Academy of Dermatology (EADV) and the American Academy of Dermatology and a consultant Dermatologist on the UK specialist register.

Dr Chris Bower is a member of the British Association of Dermatologists, the European Academy of Dermatology (EADV) and a consultant Dermatologist on the UK specialist register

Ilumetri (tildrakizumab) is a prescription medicine used to treat moderate to severe plaque psoriasis in adults. It is a biologic medicine that works by blocking a protein called interleukin-23 (IL-23). IL-23 is involved in the inflammation that causes psoriasis. Ilumetri is given as a subcutaneous injection (under the skin) once every 12 weeks. It is important to follow your doctor's instructions carefully when using Ilumetri.

How does Ilumetri work?

Ilumetri works by blocking IL-23, a protein that is involved in the inflammation that causes psoriasis. When IL-23 is blocked, it helps to reduce the inflammation and redness of the skin that is caused by psoriasis.

How is Ilumetri taken?

Ilumetri is given as a subcutaneous injection (under the skin) once every 12 weeks. It is important to follow your doctor's instructions carefully when using Ilumetri.

What are the side effects of Ilumetri?

Ilumetri can cause some side effects, including:

  • Injection site reactions
  • Upper respiratory infections
  • Sinus infections
  • Headache
  • Back pain
  • Muscle pain
  • Fatigue
  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Dizziness
  • Rash
  • Dry skin
  • Itching
  • Redness
  • Pain
  • Swelling
  • Hives

If you experience any of these side effects, tell your doctor right away.

Is Ilumetri safe for me?

Ilumetri is not safe for everyone. You should not use Ilumetri if you have any of the following:

  • An allergy to tildrakizumab
  • A severe infection
  • A weakened immune system

If you are not sure if Ilumetri is safe for you, talk to Dr. Anthony Downs, Consultant Dermatologist..

What are the risks of using Ilumetri?

Side-effects are rare especially compared to other types of biologics.

If you are concerned about the risks of using Ilumetri, talk to Dr. Anthony Downs, Consultant Dermatologist.

Important Safety Information

Ilumetri (tildrakizumab) is a prescription medicine used to treat moderate to severe plaque psoriasis in adults. It is a biologic medicine that works by blocking a protein called interleukin-23 (IL-23). IL-23 is involved in the inflammation that causes psoriasis.

Ilumetri is given as a subcutaneous injection (under the skin) once every 12 weeks. It is important to follow your doctor's instructions carefully when using Ilumetri.

What should I do if I have questions about Ilumetri?

If you are considering using Taltz to treat psoriasis get in touch with us today

Ilumetri injection
MedicationHow it worksHow it is givenSpeed of actionUnsuitable patientsCommon side-effectsPre-treatment testsCost per month after loading doses*
Ilumetri®IL-23 inhibitor100 or 200mg with self-injector. Second loading dose after 4 weeks then every 12 weeksWithin 28 weeksPregnancy or breast feeding, active TB, avoid live vaccinesnoneBlood tests and chest Xray£720
Ilumetri Tildrakizumab information sheet download South West Dermatology

*Approximate 2023 prices. Includes cold chain home delivery. Excludes initial and expected on-going face-to face or video consultation fees and any blood tests or additional investigations required. Please note routine monitoring blood tests are not required for this medication.

If you feel this is the type of medication for you, then book in a consultation with Dr Anthony Downs. For patients outside the south west area Dr Downs is able to offer remote video consultations.

Please note your private medical insurance may not cover costs of medication or ongoing consultations for chronic medical conditions.

Dr. Anthony Downs has over 20 years experience in prescribing biologics for patients with moderate to severe psoriasis. He has contributed to global clinical trials that have led to these medicines being licenced and continues to be active in clinical research in this field of medicine.

Call Sarah on 01392 350059 to book a biologic psoriasis consultation with our Consultant Dermatologist Dr. Anthony Downs. For further information call us or use our online form.

Psoriasis is a chronic autoimmune disease that causes the rapid buildup of skin cells. This can lead to patches of thick, red, scaly skin called plaques. Psoriasis can affect any part of the body, but it is most common on the scalp, elbows, knees, and back.

There is no cure for psoriasis, but there are a number of treatments that can help to control the symptoms. There are many different treatments for psoriasis, including topical creams, light therapy, and oral medications. In some cases, biologics may be used to treat psoriasis. South West Dermatology can offer biological treatment for psoriasis with Dr. Anthony Downs having over 20 years experience in prescribing biologics for patients with moderate to severe psoriasis.

What are biologics?

Biologics are a type of medication that is made from living organisms. Biologics work by targeting specific proteins in the immune system that are involved in the development of psoriasis.

There are many different types of biologics available, and they work in different ways. Some biologics block the production of certain proteins that are involved in inflammation, while others target specific immune cells.

How do biologics work?

Biologics are made from living organisms, such as bacteria or immortal cell lines. They are designed to target specific proteins in the immune system that are involved in the development of psoriasis. By blocking these proteins, biologics can help to reduce inflammation and clear up the skin.

How are biologics used to treat psoriasis?

Biologics are usually given by injection or infusion. The frequency of injections or infusions will vary depending on the type of biologic that you are taking. They can be used alone or in combination with other treatments. Some people see a significant improvement in their psoriasis within a few weeks of starting treatment, while others may not see any improvement.

What are the benefits of biologics?

Biologics can be very effective in treating moderate to severe psoriasis and tend to have fewer side effects than other types of psoriasis treatments. The effectiveness of biologics varies from person to person. 

What are the side effects of biologics?

Biologics can be a very effective treatment for psoriasis, but they are not without risks. 

Biologics can increase the risk of certain infections, such as tuberculosis and pneumonia. They can also increase the risk of some types of cancer, such as lymphoma. 

Are biologics the right psoriasis treatment right for me?

Consultant Dermatologist Dr. Anthony Downs can help you decide if biologic therapy is right for you and look at your own risks and the potential benefits of biologics before starting any treatment. For patients outside the south west area Dr. Downs is able to offer remote video consultations.

What are the costs of biologics?

Biologics can be very expensive. The cost of biologics will vary depending on the type of biologic that you are taking and your insurance coverage you have.

Call Sarah today on 01392 350059 to book a psoriasis consultation with our Consultant Dermatologist Anthony Downs. For further information call us or use our online form.

Taltz (ixekizumab) is a biologic medication that is used to treat moderate to severe plaque psoriasis in adults and children 6 years of age and older. It is also used to treat psoriatic arthritis in adults. Taltz works by blocking a protein called interleukin-17A (IL-17A), which plays a role in the inflammation that causes psoriasis.

How does Taltz work?

Taltz is a biologic medication, which means it is made from living cells. It is a monoclonal antibody that targets IL-17A, a protein that plays a role in the inflammation that causes psoriasis. By blocking IL-17A, Taltz helps to reduce inflammation and clear up psoriasis plaques.

How is Taltz taken?

Taltz is given as a subcutaneous injection. You can give yourself the injection at home after you have been trained by your doctor or nurse. The injection is given once every 4 weeks.

What are the side effects of Taltz?

Taltz can cause some side effects, including:

  • Infections
  • Infusion reactions
  • Headache
  • Upper respiratory tract infection
  • Nausea
  • Vomiting
  • Diarrhea
  • Rash
  • Pain at the injection site

Is Taltz safe?

Taltz is generally safe, but it is important to talk to your doctor about the risks and benefits of treatment before you start taking it. Taltz can increase your risk of serious infections, including tuberculosis and infections caused by bacteria, viruses, and fungi. It is important to tell your doctor if you have any history of infections before you start taking Taltz.

Is Taltz effective?

Taltz is a very effective treatment for psoriasis. In clinical trials, up to 90% of patients who took Taltz saw a significant improvement in their psoriasis plaques at 12 weeks. Four out of 10 patients achieved completely clear skin at 12 weeks.

If you are considering using Taltz to treat psoriasis get in touch with us today

MedicationHow it worksHow it is givenSpeed of actionUnsuitable patientsCommon side-effectsPre-treatment testsCost per month after loading doses*
Taltz®IL-17 inhibitor80mg monthly with self-injector. 160mg loading doseWithin 12 weeksInflammatory bowel disease, pregnancy or breast feeding, active TB, avoid live vaccinesCandida and fungal infections. Allergic reactionsBlood tests and chest Xray£780

*Approximate 2023 prices. Includes cold chain home delivery. Excludes initial and expected on-going face-to face or video consultation fees and any blood tests or additional investigations required. Please note routine monitoring blood tests are not required for this medication.

If you feel this is the type of medication for you, then book in a consultation with Dr Anthony Downs. For patients outside the south west area Dr Downs is able to offer remote video consultations.

Please note your private medical insurance may not cover costs of medication or ongoing consultations for chronic medical conditions.

Dr. Anthony Downs has over 20 years experience in prescribing biologics for patients with moderate to severe psoriasis. He has contributed to global clinical trials that have led to these medicines being licenced and continues to be active in clinical research in this field of medicine.

Call Sarah on 01392 350059 to book a biologic psoriasis consultation with our Consultant Dermatologist Dr. Anthony Downs. For further information call us or use our online form.

Psoriasis is a chronic autoimmune disease that causes the rapid buildup of skin cells. This can lead to patches of thick, red, scaly skin called plaques. Psoriasis can affect any part of the body, but it is most common on the scalp, elbows, knees, and back.

There are many different treatments for psoriasis, including topical creams, light therapy, and oral medications. For some people, these treatments are not effective enough or they cause unwanted side effects. In these cases, biologics may be a good option.

Biologics are a type of medication that works by targeting the immune system. They are typically used to treat moderate to severe psoriasis. Biologics can be very effective in clearing up psoriasis, and they often have fewer side effects than other treatments.

Here are five reasons to consider switching to biologics for psoriasis:

  1. They are more effective than other treatments. Biologics have been shown to be more effective than other treatments for psoriasis, including topical creams, light therapy, and oral medications. In clinical trials, biologics have been shown to clear up psoriasis in up to 80% of patients.
  2. They have fewer side effects. Biologics tend to have fewer side effects than other treatments for psoriasis. Common side effects of biologics include injection site reactions, infections, and an increased risk of certain types of cancer. However, these side effects are usually mild and go away on their own.
  3. They are more convenient. Biologics are typically given as injections once or twice a month. This is more convenient than other treatments for psoriasis, such as topical creams, which need to be applied daily.
  4. They are more affordable. The cost of biologics can be high, but there are many programs available to help patients pay for them.
  5. They can improve your quality of life. Psoriasis can have a significant impact on your quality of life. It can cause pain, itching, and embarrassment. Biologics can help to improve your quality of life by clearing up your psoriasis and reducing your symptoms.

If you are considering switching to biological treatment for psoriasis, talk to Dr. Anthony Downs. Dr. Downs can help you decide if biologics are right for you and make the best decision for your individual needs.

Here are some additional things to consider when deciding whether or not to switch to biologics for psoriasis:

  • Your medical history
  • Your current treatment plan
  • Your insurance coverage
  • Your budget

If you have any questions or concerns about biologics, get in touch with us today. 

If you feel this is the type of medication for you, then book in a consultation with Dr Anthony Downs. For patients outside the south west area Dr Downs is able to offer remote video consultations

Dr. Anthony Downs has over 20 years experience in prescribing biologics for patients with moderate to severe psoriasis. He has contributed to global clinical trials that have led to these medicines being licenced and continues to be active in clinical research in this field of medicine.

Call Sarah today on 01392 350059 to book a psoriasis consultation with our Consultant Dermatologist Anthony Downs. For further information call us or use our online form.

Dr Chris Bower Consultant Dermatologist of South West Dermatology presenting at Dermatology Live Bristol

In mid-May Dr Bower and Dr Downs attended the Bristol Dermatology Live meeting to deliver and chair a Dermatology meeting for Dermatology doctors and nurses from the South West of England and Wales.

A European flavour on Eurovision weekend was added by our Italian guest speaker Dr Burlando from Genoa. There were consultant led talks on contact dermatitis, psoriasis, vitiligo and hidradenitis. Despite the rail strikes the meeting was well attended and a great opportunity to exchange ideas and expert clinical experience.

These events offer important continuous professional development for our skin experts and ensure our Consultant Dermatologist stay on top of innovation, evolving technology and any medical industry developments.

Attendance helps to re-assure that South West Dermatology's clinical practice is consistent with the very best available patient care and is very often the most useful aspect of attending these meetings.

Dr Bower and Dr Downs both attended the Spring EADV meeting in Seville last week. This popular pan-European conference provides a platform to view current Dermatology clinical practice and Dermatology scientific research from different countries, including the UK.

Post-Brexit, it is important that UK Dermatologists increase their involvement in European institutes such as the European Academy of Dermatology in order to continue to influence the development and direction of this organisation.

EADV Conference 2023 in Seville presentation

This annual meeting offers important continuous professional development for our skin experts and ensures our Consultant Dermatologist stay up to date and also share best practice, innovation, embrace evolving technology and keep abreast of medical industry developments.

Attendance helps to re-assure that South West Dermatology's clinical practice is consistent with offering the very best available patient care.

In association with the Lions charity in Honiton Dr Tony Downs, Consultant Dermatologist carried out a mole/skin check for the local East Devon population on Saturday 21 May 2022.

Over 100 people were seen throughout the morning raising money for the Honiton Lions charity that supports many local ventures in and around Honiton and East Devon.

Dr Tony Downs Dermatologist at Lions Charity mole-skin check at Honiton, Devon

A number of probable melanomas and non-melanoma skin cancers were identified at this event and these will proceed to hospital NHS surgery through their local GPs.

Melanoma is the 7th commonest cancer and Devon and Cornwall has four times the national average.

Getting your skin checked out by a competent doctor picks up potentially serious problems earlier.

A big thank you to everyone involved and to all those who attended to support this worthwhile event.

If you have any concerns about your skin or a suspicious mole please get it checked by a medical professional. Look out for a mole which changes progressively in shape, size and/or colour. You can check your moles by learning the ABCDE of moles. This covers a range of features that can help you spot if a mole is becoming cancerous.

Dr. Anthony Downs runs a mole check clinic or you can upload a photo using our online form to get an initial evaluation.

The Spring European Academy of DermatoVenereology (EADV) 2022 was held in Ljubljana, Slovenia 12th to 14th May this year face to face, after two years of virtual conferences.

Dr Tony Downs & Dr Chris Bower at EADV Sprint Conference 2022

Dr Downs and Dr Bower were able to attend alongside a small group of other British Dermatologists in this important medical industry event.

European Academy of DermatoVenereology draws mostly from Europe and is the key driver of Dermatology education and research for European Dermatologists.

There were a variety of dermatology lectures and tutorials to attend and Dr Downs found the lasers, skin surgery and skin cancer recognition sessions particularly useful.

These events offer important continuous professional development for our skin experts and help Consultant Dermatologist to stay on top of innovation, evolving technology and medical industry developments.

Attendance helps to re-assure that South West Dermatology's clinical practice is consistent with the very best available patient care and is very often the most useful aspect of attending these meetings.

You have been prescribed a course of Isotretinoin for your acne. This information should be read together with the patient information leaflet by the manufacturer of this product.


What is Isotretinoin?

This is a drug which is used to treat and cure acne. The drug is only available from a Dermatology consultant on prescription. The drug needs to be taken for a specified length of time, which will be explained to you by your doctor.

How is it given?

The capsules should be taken by mouth once a day. Always make sure that you take the capsule on a full stomach and never on an empty stomach.

Is there anything I should avoid?

-        Avoid alcohol completely, or only drink small quantities of alcohol, during the treatment course.
-        Do not take vitamin A supplements in the form of oral or powder multivitamins.
-        Do not take certain prescribed medicines such as Tetracyclines (eg Oxytetracycline, Lymecycline, Doxycycline, Minocycline) or Methotrexate.

Are there any side-effects?

Very common side effects include dryness to the face, arms, hair, throat, lips and eyes. The skin is more fragile, so wound and cuts take longer to heal and removing hair by waxing should be avoided.

-        You are twice as likely to burn in strong sunshine. This is less of a problem once you have acquired a protective suntan.

-        You will not be able to give blood.

-        If you are female, you must not become pregnant whilst on this tablet and for 3 months afterward you have stopped the tablet, as you will have a malformed baby and would be strongly recommended to have a termination of the pregnancy. Effective contraception is strongly recommended in fertile women with male partners. Equally men should not attempt to father a child whist on isotretinoin.

-        Women’s periods also become irregular on this treatment.

-        Skin and nail infections are more common on this treatment.

-        Muscles and joints can ache. This is much more likely if you do a lot of exercise, or the older you are when you take this treatment.

-        Less common, or rare side-effects include a decrease in night vision, a rise in cholesterol or triglycerides, inflammation of the liver or pancreas, temporary hair thinning, in-growing toe and fingernails and precipitation of gout attack.

-        A very rare side-effect, known as benign intra-cranial hypertension, can also occur. This presents with vomiting, a severe early morning headache and blurred vision.

-        Inflammatory bowel symptoms can be worsened or triggered.

Your doctor will tell you which side0effects you are more likely to suffer from and which ones are extremely unlikely. If the dosage of tablets is reduced or stopped completely, the side-effects will go away. Make sure you talk to your doctor before making any changes to your medication, if you are suffering from any symptoms.

Flare of acne

This can happen to one in ten people that start isotretinoin. The flare is no worse than a flare of your typical acne and settles with 4 weeks. It is not related to your starting dose of medication. Very rarely a severe inflammatory reaction that mimics severe acne can happen. This is usually controlled by adding in oral steroid tablets alongside a reduced dose of isotretinoin.

Mood changes

Because acne causes low self-esteem and depression, it is common to see patients develop depression before or after starting isotretinoin. Unrelated depressive mood changes have been reported after starting isotretinoin. It remains uncertain if these reports are co-incidental or related to the medication. If you have any mood changes, you should report these to your doctor, GP, friends and family.

Effects on sexual activity

Very rarely a wide variety of symptoms have been reported including reduced libido. Not many cases have been reported, and only in the last few years. These symptoms can start during or after completing a course of treatment and can persist.

Peanut or Soya Allergy

Isotretinoin is contra-indicated in those with a known peanut or soya allergy. Peanuts share proteins with soya. Soya allergy is against soya protein and not soya oil. Isotretinoin capsules contain soya oil. Any soya protein within the capsules is either heavily modified or absent. The risk of having an allergic reaction is therefore theoretical rather than likely. Your doctor may wish to carry out further investigations to establish if you have a Type 1 allergy to peanut or soya and may wish to start your treatment in the clinic rather than at home.

Blood tests

You will need one blood test before you start treatment and at least one blood test approximately six weeks into treatment. It is very rare to require any further blood tests. These blood tests will be 9am fasting samples (no food or drink except for water from 9pm the night before the blood test).

What are the risks of having treatment or not having treatment?

There are no long-term risks of having treatment. All side-effects will go away once the treatment is stopped. The treatment course must be completed in full, otherwise a successful cure of your acne will not happen.

What are the benefits?

There is a 95% (95 out of 100) chance of you curing your acne with a single course of at least 4 months at a dose of 1mg/kg per body weight per day. Course extensions may be required if you are still spotty after 4 months treatment.

There is a 60% chance of curing your acne if you are older than this.

Lower dosage courses have a reduced chance of curing your acne or not curing you at all.
Please note that isotretinoin is also prescribed by Dermatologists for other types of skin conditions using different dosages and protocols.

Are there any alternatives to this medication?

There are no known alternative acne cures.

Other medications

Please tell your doctor if you are on any other medications or supplements before you start treatment, or if you start anything during treatment.

What if there is a problem with taking the medication?

The capsules need to be swallowed whole and cannot be crushed or split open. If you miss your dose that day, do not take a double dose on the next day.

You need to finish all the tablets that have been given to you. By missing a dose, your treatment course will be one day longer.

Storing your medication

Store the tablets in a cool, dark place. Keep these capsules away from children.

Repeat prescriptions

Your GP cannot prescribe you this drug. This drug is only available from a consultant Dermatologist.

Who can I call if I have any problems?

You will be reviewed at least once during your treatment course. Questions and problems can be discussed at this consultation. Most problems regarding this medication can be discussed over the phone or by email.

Anthony Downs, Consultant Dermatologist at AAD Annual Meeting, Boston

Consultant Dermatologist Anthony Downs attended the American Academy of Dermatology meeting in a very chilly Boston, America at the end of March 2022.

It has been two years since the meeting has been face to face and it was great for dermatologist and medical skincare professionals to re-connect with old friends and colleagues who practice dermatology in America and across the world at this international meeting.

The meeting is an important annual event for doctors that want to hear about new imminent treatments and clinical research developments in dermatology and essential continuous professional development for our skin experts.

Dr. Anthony Downs brought back many useful tips and advice that can be applied to his patients at home in the South West of England.

Hot topics in this year's AAD meeting focused around emerging eczema treatments and the relentless rise of skin cancer.

The annual UK Dermatology course for Dermatologist Consultants has been running for over 20 years and is consistently popular.

The annual UK Dermatology course for Consultants November 2021 feature image

For the last two years this event has been hosted online, but this year saw the welcome return of the face-to-face meeting which Dr Anthony Downs, Consultant Dermatologist attended late November in London.

This meeting provides a resource to discuss recent therapeutic advances that impact current clinical Dermatology practice.

Topics this year included acne, leg ulcers, scars, lupus and JAK inhibitors.

Patients expect their doctors to be up-to-date, but this does not always mean recommending a treatment just because it is new. Gathering opinions from other expert colleagues in meetings such as these help our skin specialist decide what is reliable, effective, safe and appropriate for my patients.

These events offer important continuous professional development for our skin experts and help Consultant Dermatologist to stay on top of innovation, evolving technology and medical industry developments.

Dr Chris Bower, chair of Derma Exchange presenting at the Dermatology care meeting in Bristol

Dr. Anthony Downs & Dr. Christopher Bower recently attended a face to face national Dermatology meeting in Bristol. The DermaExchange event was sponsored by Almirall and chaired by Consultant Dermatologist Dr. Christopher Bower.

This event was the first time dermatologist and healthcare professionals have been able to meet as a professional body for almost two years.

The event included lectures on clinical updates and advances in dermatology care, alongside informative lectures and discussions on mental health and the well being of both the doctor and patient.

'How to work smarter and not harder', given the overwhelming demand for our services, was a talk that was particularly well received by the audience.

Both Dr. Anthony Downs & Dr. Christopher Bower came away with some useful tips that should help with some of our more challenging patients.

We do hope the pandemic will not cut these important industry meetings that are essential for clinical professional development.

Since 2007 Dr. Anthony Downs and Dr. Christopher Bower have co-hosted delivered a national intense training course to training grade Dermatologists in order to help them pass the SCE exam.

After medical school it takes at least 8 years to become a Consultant Dermatologist. Often longer.

The SCE is a rather tough exam that has to be passed in order to progress. Coronavirus has meant that last year and this year the course has been transferred to online interactive sessions.

This dermatology training course is always heavily over-subscribed and very popular with the 'juniors' because of the quality of teaching and the focus we can provide directed at passing the exam.

The course ended the end of July 2021 and we wish all the delegates that attended the very best of luck in their exam later this year.

Dr. Downs & Dr. Bower are looking forward to passing on their dermatology knowledge and offering further CPD, useful advice and guidance for future Dermatologist and medical professional at the next event.

Dr. Anthony Downs, Consultant Dermatologist delivered a very well attended virtual lecture on acne and acne scarring on Tuesday 27 July to GPs in the South West area.

NICE acne and acne scarring national guidelines were updated last month with additional attention and recommendations on the need to provide psychological support and acne scarring advice to patients with this medical disease.

South West Deramtology Actions of Anti-Acne Therapies - Dr Tont Downs Acne Presentaion to GPs

Acne can have serious and persistent mental effects that can remain for many years and well after the acne has abated naturally or with treatment. Very few patients have access to laser treatment in the UK to treat acne scarring regardless of this recommendation in the NICE guidelines.

This evening these issues were debated as well mapping out current best clinical practice and what new emerging treatments may be available on prescription.

Dr. Anthony Downs, Consultant Dermatologist gave Devon based GPs a skin cancer management update on Thursday 1st July via a virtual lecture hosted by Exeter Medical.


Skin cancer rates continue to rise and melanoma is now the 5th commonest skin cancer.


Whist there have been tremendous advances in the last five years in treating and curing patients with melanoma over 50% still die when this disease is advanced. Early recognition and treatment remains essential. The South West has four times the national average of skin cancer.

The COVID pandemic has not helped with patients having to wait a great deal longer for NHS access to surgery by specialist whist their skin cancer continues to grow. Timely intervention by GPs can help reduce the skin cancer burden.

One of the notable differences between the UK and Australia, a country with higher skin cancer rates than the UK, is their lower death rate. This is because Australians proactively undergo routine and sometimes annual full body skin checks with their GP or their Dermatologist. Prevention being preferable to cure.

Full body mole checks are not generally available on the NHS, although your GP will always look at any mole that concerns you. South West Dermatology offer a full body mole check service undertaken by Dr Anthony Downs, Consultant in Dermatology Medicine and Surgery.  Dr Downs will make a full assessment of your moles using a dermatoscope.

Dr. Downs is happy to receive a photograph via his online form if you would like an initial opinion on an individual mole. 

Dr. Downs is continues to look forward to passing on his knowledge and offering further useful advice and guidance for doctors at the next event.

Call Ros today on 07838 293968 to book a full body mole check with Consultant Dermatologist Dr. Downs. For further information call us or use our online form.

On 6th May 2021, Dr. Anthony Downs, Consultant Dermatologist, provided an on-line (via Teams) national lecture on the use of lasers in dermatology and cosmetic practices.

This was a great opportunity for Dr. Downs to share his in-depth knowledge and experience looking at the growth in the usage of lasers and IPL for medical and cosmetic application. The attendees were dermatology colleagues throughout the UK looking to add to their continual professional development.

In the mid 1990’s cosmetic treatments were de-regulated. This led to a boom in the industry, but meant anyone could buy a laser and treat patients/clients without the need for any training or professional qualifications. Before that time only qualified doctors could see and treat patients.

Less skin laser treatments are now funded by the NHS as they are now deemed cosmetic, even though lasers have very good medical disease use and can improve disfigurements such as birth marks or scars. That also means less exposure to lasers and their applications for NHS consultant and trainee Dermatologists.

Dr. Downs is continues to look forward to passing on his knowledge and offering further useful advice and guidance for doctors at the next event.

Dr. Downs recently provided local GPs in Devon with a Zoom based educational session on peri-ocular skin conditions. This professional development session was well attended by local GPs and was some what topical given the current circumstances.

Peri-ocular dermatitis is a common dermatological disorder characterised by inflammation of the eyelids and the skin surrounding the eyes. The cause of peri-ocular dermatitis is not completely understood, but it is thought to be due to a combination of genetic and environmental factors. Peri-ocular dermatitis may be related to an impaired skin barrier – there is an association between atopic dermatitis and peri-ocular dermatitis, disturbance of follicular microflora and/or alteration of the pilosebaceous unit.

There are a number of specific medical and dermatology conditions which need treating or investigation, that present with lumps, bumps or rashes around the eyes.

Equally Dermatologists are adept at providing cosmetic treatments such as lasers for removing blemishes and wrinkles around the delicate structures of the eyes.

Dr. Downs is continues to look forward to passing on his knowledge and offering further useful advice and guidance for doctors at the next event.

On Thursday 4th March Dr. Anthony Downs, Consultant Dermatologist, provided a series of on-line medical educational interactive lectures via Zoom looking at how to diagnose and treat hair conditions for local GPs in Devon & Cornwall.

There are a number of important infections and inflammatory hair conditions that GPs need to be able to identify, either to treat or refer to a Dermatology specialist.

GPs may be the first point of call for their patients concerned about excess hair or hair loss. It is important to investigate those that may be caused by an underlying medical condition and to also refer those that are cosmetic to a Dermatology specialist where the patient wants advice and guidance about potential treatment options.

Dr. Downs is continues to look forward to passing on his knowledge and offering further useful advice and guidance for doctors at the next event.

On 21 January 2021 Dr. Tony Downs, Consultant Dermatologist was a conference speaker at the national Dermatologists virtual meeting hosted by the Royal Society of Medicine.

Dr. Downs presented on 'Inflammoscopy: no rash or hairy decisions' to a well attended meeting with an audience of over 250 delegates. He presented to fellow consultant colleagues about improving their diagnostic skills enabling them to further their CPD with accreditation.

South West Dermatology Charity Mole Check Event Exeter Slider

Other topics discussed at the event were:

  • Dermoscopy of common benign skin lesions
  • Malignoscopy: when to treat

The The Royal Society of Medicine (RSM) provides learning and support using expert speakers and global thought leaders providing essential medical insight. The RSM is a membership organisation with over 22,000 members in the UK and internationally.   It aims to bringing together doctors and healthcare professionals across specialties, with a vision to be a driving force in advancing health and patient care through education and innovation.

A clinical study by Dr Anthony MR Downs, DMC Healthcare Ltd & Dr Ian H Coulson Burnley General Teaching Hospital

YouTube® is the most popular internet-based search engine with a large body of educational Dermatology content. This information platform is more concerned with freedom of content rather than accuracy any of the scientific material.

In addition, unfiltered comments on YouTube® videos can be equally favourable or spiteful. Comments and videos can be deliberately misleading, designed for financial gain or champion bizarre alternative health beliefs.

Despite the unpredictability of YouTube® content it presents an opportunity to provide patients with additional information about their disease and treatment. That should improve adherence and facilitate informed consent.

Patients referred to our service with acne unresponsive to primary care treatment were sent a YouTube® link to www.youtube.com/watch?v=tlbZzqtgBvE.

At initial consultation, those patients that had viewed the video (irrespective whether isotretinoin was prescribed) and the clinician were asked to provide feedback on the video and the consultation.

A sample of 50 patients were reviewed. Age range 13 to 49 (mean of 21) of which 35 were female. Clinicians felt that the consultations were shorter (90%) and easier (90%). Isotretinoin was clinically indicated and started in 90% of patients. Only 5% of consultations took longer than normal.

Some patients felt an isotretinoin written information leaflet as well as the video were not necessary (40%) and face-to-face consultations completely necessary (100%). Of those that chose to be treated with isotretinoin, 95% confirmed the video helped in their decision and helped their consultation experience. Only one patient with a pre-existing anxiety state was worried by the video content.

This video offers an opportunity to offer an alternative information format to compliment the traditional consultation and written information. It shows photographs of treatment responses and side-effects that other written formats, do not.

We believe it helps prepare patients for the consultation by providing them with knowledge that allows for a faster and more constructive dialogue with the clinician.

29th European Academy of DermatoVenereology Congress was hosted virtually this year 29th-31st October 2020.

About EADV

Founded in 1987, EADV is the leading community to further the knowledge of health professionals and advocates in the field of dermatology and venereology. It is a non-profit organisation with over 7,000 members, across 113 different countries in the world, providing a valuable service for every type of dermato-venereologist professional.

The EADV is committed to improving the quality of patient care, continuing medical education for all dermato-venereologists in Europe and beyond, and advocacy on behalf of the speciality and patients.

This year's congress was titled: EADV Virtual - New Frontiers in Dermatology and Venereology and provided an exceptional opportunity for colleagues from around the world to explore the latest developments in science and patient care that are at the heart of the academy’s mission. There were over 11,000 attendees from 112 countries.

Dr. Anthony Downs, Consultant Dermatologist presented two clinical studies:

Incorporating a pre-consultation on-line isotretinoin video adds value to acne patient management

Incorporating a pre-consultation on-line isotretinoin video adds value to acne patient management

The provision of a YouTube acne videos to patient's prior to their acne consultation. This helps inform patients to make difficult choices about strong treatments prior choosing that treatment, also in a format teenagers and young adults can more easily relate to.

Walk-in mole/skin check - What are the perceived health values?

Walk-in mole skin check - What are the perceived health values

The health value of a charitable and free walk-in mole check with a specialist for people concerned about skin cancer.

Book a consultation

Dr Anthony Downs Exeter Consultant Dermatologist & skin expert Devon
Appointments with
Dr Anthony Downs in Devon (Exeter) 
Call Sarah on 01392 350059
Dr Anthony Downs Exeter Consultant Dermatologist & skin expert Devon
Appointments with
Dr Anthony Downs in Cornwall (Truro)
Call Angela on 07421 022801
Appointments with
Dr Christopher Bower in Exeter (Exeter Nuffield)
Call Ros on 07838 293968

For non-urgent enquiries get in touch online

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