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Acne Management

This treatment plan reviews the risks and benefits of the treatment we are recommending. Please make sure to read it and the manufacturer's pamphlet that comes with the medicine. The manufacturer's pamphlet contains the full information on interactions, side effects, and other important information you should know about the medicine before you start.

Instructions

You have stated that you wish to take a topical medication for your acne symptoms. Apply 1 pump (pea sized amount) to face at bedtime. Use one pump and apply a dab to the forehead, left cheek, right cheek and chin and rub in to cover the whole face. If skin sensitivity such as peeling, redness, irritation occurs this is a normal response to tretinoin based products. If this occurs you may dilute the pea sized amount with a moisturizer 50/50 and/ or reduce the frequency to every other night until your skin adjusts.

Clindamycin targets acne forming bacteria and reduces inflammation to reduce pain and redness, tretinoin boosts cell turnover to reveal clear skin fast, and niacinamide works to soothe and repair.

Refills

[Subscription patients only] You will automatically be sent a refill every 90 days (subject to a refill visit to help screen for side effects). You may request a refill early by logging into your Account (Subscriptions > Next Refill) or placing a new one-time order.

If your symptoms aren't getting better after you start taking the medicine or if you develop new or worsening symptoms such as fever, chills, nausea, vomiting, or pain, you should see a doctor in-person and call or message us immediately. While some redness/dryness/irritation or peeling are common and expected, if you feel you are having a more significant/allergic reaction (severe rash, itching, hives or swelling) please discontinue use immediately and message your doctor. Furthermore, if your symptoms are not simply acne, then an in-person exam with a physician is necessary to determine a correct diagnosis.

Active Ingredients

This medicine contains the following active ingredients. If you are allergic to any of these components, similar components, or any of the others components listed in the manufacturer's pamphlet do not take it and call or message us immediately:

• Tretinoin 0.04%
• Clindamycin 1.25%
• Niacinamide 4%
  
  

Allergies/Contraindications

This medicine may cause an allergic reaction if you are allergic to similar medicines or components. If you are allergic to any of the following, please stop taking the medicine and message your wisp doctor, or seek an in-person:

• Tretinoin
• Retinol
• Clindamycin (oral or topical)
• Isotretinoin (Accutane)
  
  

Conditions

We have evaluated your health history and the specific health information you provided us, however if anything changes and you develop or discover that one of these conditions applies to you please stop taking this medicine and call or message us immediately:

• Pregnancy
• New rashes or suspected allergies.
  
  

Pregnancy and Breastfeeding

This is not recommended for use during pregnancy or breastfeeding due to the potential for side effects in the infant.

Emergency Side Effects

This medicine can cause dangerous and potentially life threatening side effects. If any of the emergency side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call 911 or seek immediate medical help in-person:

• Severe skin rash, blistering or changes
• Mucosal (eyes, mouth) rash/peeling
• Shortness of breath or wheezing
• Pregnancy
  
  

Medicines, Supplements, and Foods

We have evaluated your health history and the specific health information you provided us, however if anything changes and you start or discover that you are taking any of the medicines, foods, or supplements listed below call or message us before you take the medicine. Some of these can cause dangerous interactions with the medicine we are prescribing you and we will help you evaluate that risk and decide on an appropriate treatment plan:

• Isotretinoin (Accutane)
• Oral antibiotics
• Birth control
• Spironolactone
• Any new prescription topical medications
  
  

Accurate Information

We have evaluated the specific health information you provided and are making our recommendations based on it. If you forgot to provide or incorrectly provided that information we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. If you need to clarify or update any information about your health you can message or call us anytime.

Treatment Failure

This treatment is not 100% effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency call 911 or seek immediate medical help in-person. You may need to seek alternative treatment such as those listed below or in the follow-up plan.

Misdiagnosis or Delayed Diagnosis

There is also a risk that we may incorrectly diagnose or fail to diagnose the correct conditions that you may have, thereby affecting our recommendation for treatment. This risk exists with in-person care as well, but they may have additional clinical history, physical exam findings and tests to aid their evaluation. We use evidence-based practice guidelines and clinical decision making to try to minimize these risks. Here are some other diagnoses that we attempt to rule out:

• Other facial rashes mimicking acne.
  
  

Accepting or Declining Our Recommendation

We are recommending this treatment for you because the potential benefits of treatment outweigh the risks. You should evaluate this information as well as the manufacturer's pamphlet, and any input from your in-person healthcare team, or other relevant information to decide if this treatment plan is appropriate for you. You are free to decline our treatment recommendations although doing so may prolong symptoms and can be associated with other risks or negative outcomes.

Alternative Treatment

We have based our recommendation on your specific case and current medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can't provide. Message us or talk to your doctor in-person to discuss alternative treatments. Here are some other treatments or strategies that you might consider:

• In-person dermatology appointment
  
  

Share with Your In-Person Healthcare Team

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.

You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.