Skin Care for Common Conditions at YourPharmacy

Differin Cream

Strength – 0.1% Adapalene

Available in 45g or 60g

£24.95 - £28.99

Differin Cream Consultation

Please answer the following questions as honestly as possible so we can ensure your preferred treatment is the best treatment for your needs.
Estimated time to complete: 2 minutes

"*" indicates required fields

Step 1 of 8

12%

Prescription Only Medication Consultation

As this is a Prescription medication it is required by law, that you have a short consultation beforehand to make sure this treatment is suitable for you. It shouldn’t take any longer than 4 minutes.

As Differin Cream is a prescription-only medication, this short consultation form is essential to make sure treatment method is safe for you.

Terms and Conditions*

I confirm and understand all of the above

Personal Information

Name*

First Last

Email Address*

Date of birth*

Day

Month

Year

Gender*

Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Medical History

Do you have any known allergies or sensitivities?*

Yes

If Yes (Please specify)

Are you currently taking any prescription or over-the-counter medications, including herbal supplements?*

Yes

If Yes (Please specify)

Do you have or have you ever had any of the following? (Check all that apply)*

Epilepsy or seizure

Fainting

Dizziness when you stand up after lying down

Bleeding or clotting disorder

ANY heart conditions

Problems with your liver or kidneys

Any mental health conditions (e.g., depression, anxiety, bipolar disorder, mania)

None of the above

Acnecide Consultation

How long have you had acne?*

Less than 3 months

3-6 months

More than 6 months

How would you describe your acne?*

Mild

Moderate

Severe

Please Upload a picture of your face*

Accepted file types: jpg, png, Max. file size: 2 GB.

This is so the pharmacist can assess whether the treatment is suitable for you, once complete the image will be deleted.

Have you ever taken anti-biotics for acne before?*

Yes

If Yes, Please specify

Previous Treatment

Have you tried any other acne treatment before?*

Yes

If Yes, Please specify

Did you experience any side effects from previous treatments?*

Yes

if Yes (Please describe)

Do you consume alcohol?*

Yes

If Yes (How often?)

Do you use any recreational drugs?*

Yes

If Yes (Please specify)

How often do you exercise?*

Rarely

1-2 times per week

3-5 times per week

Daily

What is your preferred method of contact?*

Phone

AccuRx (Secure SMS)

SMS (+447787137117)

Consent & Agreement*

All information I have provided is accurate and honest to enable YourPharmacy prescribers to make the best decision in regards to my health.

I will read, understand and follow the instructions in the patient information leaflet, including the risks and side effects, before taking my treatment.

I am happy for the YourPharmacy clinicians to contact me if necessary to ensure suitability and safety.

I am aware YourPharmacy can refuse or withdraw service without providing a reason (a refund will be issued) .

I will seek medical advice via a GP, NHS 111, walk in centre, pharmacy and if necessary, A&E if I experience any adverse effects from my treatment.

I will seek medical advice if my medical circumstances or condition changes.

I consent to be contacted via AccuRx, Email or by Phone.

I agree to the terms and conditions

Differin Gel

Strength – 0.1% Adapalene

Available in 45g or 60g

£24.95 - £28.99

Differin Gel Consultation

Please answer the following questions as honestly as possible so we can ensure your preferred treatment is the best treatment for your needs.
Estimated time to complete: 2 minutes

"*" indicates required fields

Step 1 of 8

12%

Prescription Only Medication Consultation

As this is a Prescription Only medication it is required to complete to a consultation so our prescribers can check and review it to safely prescribe it. It shouldn’t take any longer than 3 minutes.

Terms and Conditions*

I confirm and understand all of the above

Personal Information

Name*

First Last

Email Address*

Date of birth*

Day

Month

Year

Gender*

Medical History

Do you have any known allergies or sensitivities?*

Yes

If Yes (Please specify)

Are you currently taking any prescription or over-the-counter medications, including herbal supplements?*

Yes

If Yes (Please specify)

Do you have or have you ever had any of the following? (Check all that apply)*

Epilepsy or seizure

Fainting

Dizziness when you stand up after lying down

Bleeding or clotting disorder

ANY heart conditions

Problems with your liver or kidneys

Any mental health conditions (e.g., depression, anxiety, bipolar disorder, mania)

None of the above

Acnecide Consultation

How long have you had acne?*

Less than 3 months

3-6 months

More than 6 months

How would you describe your acne?*

Mild

Moderate

Severe

Please Upload a picture of your face*

Accepted file types: jpg, png, Max. file size: 2 GB.

This is so the pharmacist can assess whether the treatment is suitable for you, once complete the image will be deleted.

Have you ever taken anti-biotics for acne before?*

Yes

If Yes, Please specify

Previous Treatment

Have you tried any other acne treatment before?*

Yes

If Yes, Please specify

Did you experience any side effects from previous treatments?*

Yes

if Yes (Please describe)

Do you consume alcohol?*

Yes

If Yes (How often?)

Do you use any recreational drugs?*

Yes

If Yes (Please specify)

How often do you exercise?*

Rarely

1-2 times per week

3-5 times per week

Daily

Consent & Agreement*

All information I have provided is accurate and honest to enable YourPharmacy prescribers to make the best decision in regards to my health.

I will read, understand and follow the instructions in the patient information leaflet, including the risks and side effects, before taking my treatment.

I am happy for the YourPharmacy clinicians to contact me if necessary to ensure suitability and safety.

I am aware YourPharmacy can refuse or withdraw service without providing a reason (a refund will be issued) .

I will seek medical advice via a GP, NHS 111, walk in centre, pharmacy and if necessary, A&E if I experience any adverse effects from my treatment.

I will seek medical advice if my medical circumstances or condition changes.

I consent to be contacted via AccuRx, Email or by Phone.

I agree to the terms and conditions

Epiduo Gel

Strength – 0.1% Adapalene / 2.5% Benzoyl Peroxide

Available in 45g or 60g

£34.95

Epiduo Gel 0.1% Consultation

Please answer the following questions as honestly as possible so we can ensure your preferred treatment is the best treatment for your needs.
Estimated time to complete: 2 minutes

"*" indicates required fields

Step 1 of 8

12%

Prescription Only Medication Consultation

Terms and Conditions*

I confirm and understand all of the above

Personal Information

Name*

First Last

Email Address*

Date of birth*

Day

Month

Year

Gender*

Medical History

Do you have any known allergies or sensitivities?*

Yes

If Yes (Please specify)

Are you currently taking any prescription or over-the-counter medications, including herbal supplements?*

Yes

If Yes (Please specify)

Do you have or have you ever had any of the following? (Check all that apply)*

Epilepsy or seizure

Fainting

Dizziness when you stand up after lying down

Bleeding or clotting disorder

ANY heart conditions

Problems with your liver or kidneys

Any mental health conditions (e.g., depression, anxiety, bipolar disorder, mania)

None of the above

Acnecide Consultation

How long have you had acne?*

Less than 3 months

3-6 months

More than 6 months

How would you describe your acne?*

Mild

Moderate

Severe

Please Upload a picture of your face*

Accepted file types: jpg, png, Max. file size: 2 GB.

This is so the pharmacist can assess whether the treatment is suitable for you, once complete the image will be deleted.

Have you ever taken anti-biotics for acne before?*

Yes

If Yes, Please specify

Previous Treatment

Have you tried any other acne treatment before?*

Yes

If Yes, Please specify

Did you experience any side effects from previous treatments?*

Yes

if Yes (Please describe)

Do you consume alcohol?*

Yes

If Yes (How often?)

Do you use any recreational drugs?*

Yes

If Yes (Please specify)

How often do you exercise?*

Rarely

1-2 times per week

3-5 times per week

Daily

Consent & Agreement*

All information I have provided is accurate and honest to enable YourPharmacy prescribers to make the best decision in regards to my health.

I will read, understand and follow the instructions in the patient information leaflet, including the risks and side effects, before taking my treatment.

I am happy for the YourPharmacy clinicians to contact me if necessary to ensure suitability and safety.

I am aware YourPharmacy can refuse or withdraw service without providing a reason (a refund will be issued) .

I will seek medical advice via a GP, NHS 111, walk in centre, pharmacy and if necessary, A&E if I experience any adverse effects from my treatment.

I will seek medical advice if my medical circumstances or condition changes.

I consent to be contacted via AccuRx, Email or by Phone.

I agree to the terms and conditions

Epiduo Gel

Strength – 0.3% Adapalene / 2.5% Benzoyl Peroxide

Available in 45g or 60g

£36.95

Epiduo Gel 0.3% Consultation

Please answer the following questions as honestly as possible so we can ensure your preferred treatment is the best treatment for your needs.
Estimated time to complete: 2 minutes

"*" indicates required fields

Step 1 of 8

12%

Prescription Only Medication Consultation

Terms and Conditions*

I confirm and understand all of the above

Personal Information

Name*

First Last

Email Address*

Date of birth*

Day

Month

Year

Gender*

Medical History

Do you have any known allergies or sensitivities?*

Yes

If Yes (Please specify)

Are you currently taking any prescription or over-the-counter medications, including herbal supplements?*

Yes

If Yes (Please specify)

Do you have or have you ever had any of the following? (Check all that apply)*

Epilepsy or seizure

Fainting

Dizziness when you stand up after lying down

Bleeding or clotting disorder

ANY heart conditions

Problems with your liver or kidneys

Any mental health conditions (e.g., depression, anxiety, bipolar disorder, mania)

None of the above

Acnecide Consultation

How long have you had acne?*

Less than 3 months

3-6 months

More than 6 months

How would you describe your acne?*

Mild

Moderate

Severe

Please Upload a picture of your face*

Accepted file types: jpg, png, Max. file size: 2 GB.

This is so the pharmacist can assess whether the treatment is suitable for you, once complete the image will be deleted.

Have you ever taken anti-biotics for acne before?*

Yes

If Yes, Please specify

Previous Treatment

Have you tried any other acne treatment before?*

Yes

If Yes, Please specify

Did you experience any side effects from previous treatments?*

Yes

if Yes (Please describe)

Do you consume alcohol?*

Yes

If Yes (How often?)

Do you use any recreational drugs?*

Yes

If Yes (Please specify)

How often do you exercise?*

Rarely

1-2 times per week

3-5 times per week

Daily

Consent & Agreement*

All information I have provided is accurate and honest to enable YourPharmacy prescribers to make the best decision in regards to my health.

I will read, understand and follow the instructions in the patient information leaflet, including the risks and side effects, before taking my treatment.

I am happy for the YourPharmacy clinicians to contact me if necessary to ensure suitability and safety.

I am aware YourPharmacy can refuse or withdraw service without providing a reason (a refund will be issued) .

I will seek medical advice via a GP, NHS 111, walk in centre, pharmacy and if necessary, A&E if I experience any adverse effects from my treatment.

I will seek medical advice if my medical circumstances or condition changes.

I consent to be contacted via AccuRx, Email or by Phone.

I agree to the terms and conditions

Skinoren Cream

Strength – 20% Azelaic Acid

Available in 30g

£14.99

Skinoren Consultation

Please answer the following questions as honestly as possible so we can ensure your preferred treatment is the best treatment for your needs.
Estimated time to complete: 2 minutes

"*" indicates required fields

Step 1 of 8

12%

Prescription Only Medication Consultation

Terms and Conditions*

I confirm and understand all of the above

Personal Information

Name*

First Last

Email Address*

Date of birth*

Day

Month

Year

Gender*

Medical History

Do you have any known allergies or sensitivities?*

Yes

If Yes (Please specify)

Are you currently taking any prescription or over-the-counter medications, including herbal supplements?*

Yes

If Yes (Please specify)

Do you have or have you ever had any of the following? (Check all that apply)*

Epilepsy or seizure

Fainting

Dizziness when you stand up after lying down

Bleeding or clotting disorder

ANY heart conditions

Problems with your liver or kidneys

Any mental health conditions (e.g., depression, anxiety, bipolar disorder, mania)

None of the above

Acnecide Consultation

How long have you had acne?*

Less than 3 months

3-6 months

More than 6 months

How would you describe your acne?*

Mild

Moderate

Severe

Please Upload a picture of your face*

Accepted file types: jpg, png, Max. file size: 2 GB.

This is so the pharmacist can assess whether the treatment is suitable for you, once complete the image will be deleted.

Have you ever taken anti-biotics for acne before?*

Yes

If Yes, Please specify

Previous Treatment

Have you tried any other acne treatment before?*

Yes

If Yes, Please specify

Did you experience any side effects from previous treatments?*

Yes

if Yes (Please describe)

Do you consume alcohol?*

Yes

If Yes (How often?)

Do you use any recreational drugs?*

Yes

If Yes (Please specify)

How often do you exercise?*

Rarely

1-2 times per week

3-5 times per week

Daily

Consent & Agreement*

All information I have provided is accurate and honest to enable YourPharmacy prescribers to make the best decision in regards to my health.

I will read, understand and follow the instructions in the patient information leaflet, including the risks and side effects, before taking my treatment.

I am happy for the YourPharmacy clinicians to contact me if necessary to ensure suitability and safety.

I am aware YourPharmacy can refuse or withdraw service without providing a reason (a refund will be issued) .

I will seek medical advice via a GP, NHS 111, walk in centre, pharmacy and if necessary, A&E if I experience any adverse effects from my treatment.

I will seek medical advice if my medical circumstances or condition changes.

I consent to be contacted via AccuRx, Email or by Phone.

I agree to the terms and conditions

On this Page
01 Acne
02 Eczema
03 Dry Skin
04 Dandruff / Scalp Eczema
05 Actinic Keratosis

Eczema

Creams or Ointments that can help reduce symptoms of Eczema

Epimax

Available in 100g and 500g

Available in Original, Oatmeal, Isomol, Excetra and Moisturising.

£4 - £16.99

Hydromol Cream

Available in 500g

£20

Zerobase

Sizes Available:

50g or 500g

£4 - £12.99

Zerocream

Sizes Available:

50g or 500g

£4 - £12.99

Zeroveen

Sizes Available:

100g or 500g

£5.49 - £14.99

Balneum Plus Cream

Sizes Available:

100g or 500g

£5.99 - 21.99

Dry Skin

Creams or Ointments that can help reduce symptoms of Dry Skin

Aveeno Daily Moisturising Lotion

Available in 300ml or 500ml

£8.29 - £11.99

Aveeno Daily Moisturising Creamy Oil

Available in 300ml

£9.99

Oilatum Cream

Available in 500ml

£15.99

Oilatum Junior Cream

Available in 500ml

£15.99

Eucerin Urea Repair Original

Strength – 10% Urea Cream

Available in 100ml

£16.99

Flexitol Rescue Heel Balm

Strength – 25% Urea

Available in 56g or 112g

£7.99 - £13.49

Dandruff Relief/ Scalp Eczema

Shampoos and Lotions that help reduce the symptoms of Dandruff and Scalp Eczema

Nizoral

Strength – 2% Ketoconazole Shampoo

Available in 60ml

£12.99 - 19.99

E45 Dry Scalp Shampoo

Available in 200ml

£9.99

Elocon Scalp Lotion

Strength – 0.1% Mometasone Furoate

Available in 30ml

£7.99

Elocon Scalp Lotion Consultation

Please answer the following questions as honestly as possible so we can ensure your preferred treatment is the best treatment for your needs.
Estimated time to complete: 2 minutes

"*" indicates required fields

Step 1 of 7

14%

As Elocon Scalp Lotion is a prescription-only medication, this short consultation form is essential to make sure treatment method is safe for you.

Terms and Conditions*

I confirm and understand all of the above

Personal Information

Name*

First Last

Email Address*

Date of birth*

Day

Month

Year

Gender*

Medical History

Have you been diagnosed with dry skin, dermatitis, or another scalp condition by your GP or dermatologist?*

Yes

If Yes (Please give us more information)

Are you currently experiencing a flare up in your scalp condition?*

Yes

If Yes (Please specify)

Is this episode different in any way to when it was first diagnosed?*

Yes

If Yes (Please specify)

Are you currently taking any prescription or over-the-counter medications, including herbal supplements?*

Yes

If Yes (Please specify)

Elocon Scalp Lotion Consultation

How long have you had Scalp Eczema?*

Less than 3 months

3-6 months

More than 6 months

How severe is your scalp eczema?*

Mild

Moderate

Severe

Please Upload a picture of your scalp if possible

Accepted file types: jpg, png, Max. file size: 2 GB.

This is so the pharmacist can assess whether the treatment is suitable for you, once complete the image will be deleted.

Previous Treatment

Have you previously used any lotion/shampoos used to treat Scalp Eczema?*

Yes

If Yes, Please specify

Did you experience any side effects from previous treatments?*

Yes

if Yes (Please describe)

Do you use any creams/emollients?*

Yes

If Yes (How often?)

Consent & Agreement*

All information I have provided is accurate and honest to enable YourPharmacy prescribers to make the best decision in regards to my health.

I will read, understand and follow the instructions in the patient information leaflet, including the risks and side effects, before taking my treatment.

I am happy for the YourPharmacy clinicians to contact me if necessary to ensure suitability and safety.

I am aware YourPharmacy can refuse or withdraw service without providing a reason (a refund will be issued) .

I will seek medical advice via a GP, NHS 111, walk in centre, pharmacy and if necessary, A&E if I experience any adverse effects from my treatment.

I will seek medical advice if my medical circumstances or condition changes.

I consent to be contacted via AccuRx, Email or by Phone.

I agree to the terms and conditions

Betacap Scalp Lotion

Strength – 0.1% Betamethasone

Available in 100ml

£10.99

Betacap Scalp Lotion Consultation

Please answer the following questions as honestly as possible so we can ensure your preferred treatment is the best treatment for your needs.
Estimated time to complete: 2 minutes

"*" indicates required fields

Step 1 of 7

14%

As Betacap Scalp Lotion is a prescription-only medication, this short consultation form is essential to make sure treatment method is safe for you.

Terms and Conditions*

I confirm and understand all of the above

Personal Information

Name*

First Last

Email Address*

Date of birth*

Day

Month

Year

Gender*

Medical History

Have you been diagnosed with dry skin, dermatitis, or another scalp condition by your GP or dermatologist?*

Yes

If Yes (Please give us more information)

Are you currently experiencing a flare up in your scalp condition?*

Yes

If Yes (Please specify)

Is this episode different in any way to when it was first diagnosed?*

Yes

If Yes (Please specify)

Are you currently taking any prescription or over-the-counter medications, including herbal supplements?*

Yes

If Yes (Please specify)

Betacap Scalp Lotion Consultation

How long have you had Scalp Eczema?*

Less than 3 months

3-6 months

More than 6 months

How severe is your scalp eczema?*

Mild

Moderate

Severe

Please Upload a picture of your scalp if possible

Accepted file types: jpg, png, Max. file size: 2 GB.

This is so the pharmacist can assess whether the treatment is suitable for you, once complete the image will be deleted.

Previous Treatment

Have you previously used any lotion/shampoos used to treat Scalp Eczema?*

Yes

If Yes, Please specify

Did you experience any side effects from previous treatments?*

Yes

if Yes (Please describe)

Do you use any creams/emollients?*

Yes

If Yes (How often?)

Consent & Agreement*

All information I have provided is accurate and honest to enable YourPharmacy prescribers to make the best decision in regards to my health.

I will read, understand and follow the instructions in the patient information leaflet, including the risks and side effects, before taking my treatment.

I am happy for the YourPharmacy clinicians to contact me if necessary to ensure suitability and safety.

I am aware YourPharmacy can refuse or withdraw service without providing a reason (a refund will be issued) .

I will seek medical advice via a GP, NHS 111, walk in centre, pharmacy and if necessary, A&E if I experience any adverse effects from my treatment.

I will seek medical advice if my medical circumstances or condition changes.

I consent to be contacted via AccuRx, Email or by Phone.

I agree to the terms and conditions

Actinic Keratosis

Creams for Actinic Keratosis

Efudix

Strength – 5% Fluorouracil

Available in 40g

£89.99

Efudix – Actinic Keratosis

Please answer the following questions as honestly as possible so we can ensure your preferred treatment is the best treatment for your needs.
Estimated time to complete: 4 minutes

"*" indicates required fields

Step 1 of 9

11%

Efudix Cream Consultation for Actinic Keratosis

As this is a Prescription Only Medication, this is so that our team of Prescribers can safely review your consultation and make sure it is suitable for your needs.

Terms and Conditions*

I confirm and understand all of the above

Personal Information

Name*

First Last

Email Address*

Date of birth*

Day

Month

Year

Gender*

Address*

Street Address Address Line 2 City ZIP / Postal Code Country

Medical History

Have you been diagnosed with actinic keratosis by a healthcare professional?*

Yes

Where on your body are the affected areas located?*

Face

Scalp

Ears

Hands

Forearms

Other

Please select all that apply.

Please give us more details*

How long have you had these lesions?*

Less than 3 months

3-12 Months

More than 12 Months

Have any lesions changed in size, shape, or started to bleed or ulcerate?*

Yes

Please give us more details*

Please upload some pictures of the affected area(s).*

Drop files here or

Accepted file types: jpg, png, Max. file size: 2 GB, Max. files: 5.

Have you previously used Efudix or any other treatment for actinic keratosis?*

Yes

Please specify treatment and the response.*

General Health & Medication

Do you have any known allergies or sensitivities?*

Yes

If Yes (Please specify)

Are you currently using any other prescription or over-the-counter skin treatments?*

Yes

If Yes (Please Specify)

Are you taking any medications that suppress the immune system (e.g., steroids, chemotherapy, immunosuppressants)?*

Yes

If Yes (Please Specify)*

Do you have any history of skin cancer or a weakened immune system?*

Yes

If Yes, Please specify

Are you pregnant, breastfeeding, or planning to become pregnant?*

Yes

Efudix Treatment Suitability

Are you aware that Efudix causes redness, peeling, and crusting in the treated areas as part of the healing process?*

Yes

Do you understand that treated areas may become sore and inflamed before healing and that this is a normal reaction?*

Yes

Can you commit to avoiding sun exposure and using a high-factor sunscreen (SPF 50+) while using Efudix?*

Yes

Do you understand that treatment typically lasts 2-4 weeks, and you should stop earlier if severe ulceration or extreme irritation occurs?*

Yes

Are you happy to proceed with a follow-up consultation if needed after completing treatment?*

Yes

Please enter a date you would be happy to have the follow up consultation.*

Please ensure the date is a working day and is at least 16 days in the future starting from when you complete this consultation. Please note we can contact you sooner if necessary.

MM slash DD slash YYYY

Do you want YourPharmacy to share this consultation and treatment plan with your GP*

We highly recommend this to ensure your safety throughout your treatment.

Yes

Name of GP*

Do you consent for YourPharmacy to check NSCR to confirm your identity and your suitability for this treatment?*

Yes

Consent & Agreement*

All information I have provided is accurate and honest to enable YourPharmacy prescribers to make the best decision in regards to my health.

I will read, understand and follow the instructions in the patient information leaflet, including the risks and side effects, before taking my treatment.

I am happy for the YourPharmacy clinicians to contact me if necessary to ensure suitability and safety.

I am aware YourPharmacy can refuse or withdraw service without providing a reason (a refund will be issued) .

I will seek medical advice via a GP, NHS 111, walk in centre, pharmacy and if necessary, A&E if I experience any adverse effects from my treatment.

I will seek medical advice if my medical circumstances or condition changes.

I consent to be contacted via AccuRx, Email or by Phone.

I agree to the terms and conditions

Solaraze

Strength – 3% Diclofenac Sodium

Available in 50g

£67.99

Solaraze Gel – Actinic Keratosis

Please answer the following questions as honestly as possible so we can ensure your preferred treatment is the best treatment for your needs.
Estimated time to complete: 4 minutes

"*" indicates required fields

Step 1 of 9

11%

Solaraze Gel Consultation for Actinic Keratosis

As this is a Prescription Only Medication, this is so that our team of Prescribers can safely review your consultation and make sure it is suitable for your needs.

Terms and Conditions*

I confirm and understand all of the above

Personal Information

Name*

First Last

Email Address*

Date of birth*

Day

Month

Year

Gender*

Address*

Street Address Address Line 2 City ZIP / Postal Code Country

Medical History

Have you been diagnosed with actinic keratosis by a healthcare professional?*

Yes

Where on your body are the affected areas located?*

Face

Scalp

Ears

Hands

Forearms

Other

Please select all that apply.

Please give us more details*

How long have you had these lesions?*

Less than 3 months

3-12 Months

More than 12 Months

Have any lesions changed in size, shape, or started to bleed or ulcerate?*

Yes

Please give us more details*

Please upload some pictures of the affected area(s).*

Drop files here or

Accepted file types: jpg, png, Max. file size: 1 GB.

Have you previously used Solaraze or any other treatment for actinic keratosis?*

Yes

Please specify treatment and the response.*

General Health & Medication

Do you have any known allergies or sensitivities?*

Yes

If Yes (Please specify)

Are you currently using any other prescription or over-the-counter skin treatments?*

Yes

If Yes (Please Specify)

Are you taking any medications that suppress the immune system (e.g., steroids, chemotherapy, immunosuppressants)?*

Yes

If Yes (Please Specify)*

Do you have any history of skin cancer or a weakened immune system?*

Yes

If Yes, Please specify

Are you pregnant, breastfeeding, or planning to become pregnant?*

Yes

Solareze Gel Treatment Suitability

Are you aware that Solaraze is a non-steroidal anti-inflammatory gel that works over 60-90 days and may cause mild skin irritation?*

Yes

Do you understand that treated areas may become red, dry, or slightly inflamed before healing and that this is a normal reaction?*

Yes

Can you commit to avoiding excessive sun exposure and using a high-factor sunscreen (SPF 50+) while using Solaraze?*

Yes

Do you understand that treatment typically lasts 60-90 days, and you should stop earlier if severe irritation or an allergic reaction occurs?*

Yes

Are you happy to proceed with a follow-up consultation if needed after completing treatment?*

Yes

Please enter a date you would be happy to have the follow up consultation.*

Please ensure the date is a working day and is at least 16 days in the future starting from when you complete this consultation. Please note we can contact you sooner if necessary.

MM slash DD slash YYYY

Do you want YourPharmacy to share this consultation and treatment plan with your GP*

We highly recommend this to ensure your safety throughout your treatment.

Yes

Name of GP*

Do you consent for YourPharmacy to check NSCR to confirm your identity and your suitability for this treatment?*

Yes

Consent & Agreement*

All information I have provided is accurate and honest to enable YourPharmacy prescribers to make the best decision in regards to my health.

I will read, understand and follow the instructions in the patient information leaflet, including the risks and side effects, before taking my treatment.

I am happy for the YourPharmacy clinicians to contact me if necessary to ensure suitability and safety.

I am aware YourPharmacy can refuse or withdraw service without providing a reason (a refund will be issued) .

I will seek medical advice via a GP, NHS 111, walk in centre, pharmacy and if necessary, A&E if I experience any adverse effects from my treatment.

I will seek medical advice if my medical circumstances or condition changes.

I consent to be contacted via AccuRx, Email or by Phone.

I agree to the terms and conditions