Adapalene / Benzoyl Peroxide Gel - MyChemistPlus

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Consultation

Your Condition & History

Are aged between 18 and 65?(Required)

Yes

No

A supply of medication cannot be made, please contact your GP for further help and information. Thank you.

Do you have typical mild–moderate acne (blackheads/whiteheads/inflamed spots), not deep/cystic and not causing scarring?(Required)

Yes

No

A supply of medication cannot be made, please contact your GP for further help and information. Thank you.

Are you pregnant, planning pregnancy, or breastfeeding?(Required)

Yes

No

A supply of medication cannot be made, please contact your GP for further help and information. Thank you.

Do you have eczema, rosacea, broken/sunburned skin where you’ll apply treatment?(Required)

Yes

No

A supply of medication cannot be made, please contact your GP for further help and information. Thank you.

Are you using any acne treatment (topical or oral) now, or have you used any in the last 12 weeks?(Required)

Oral isotretinoin

Any topical retinoid (e.g., adapalene, tretinoin)

Clindamycin + benzoyl peroxide (e.g., Duac) in the last 12 weeks

Benzoyl peroxide only

Over The Counter cleansers/spot gels only

None of the above

A supply of medication cannot be made, please contact your GP for further help and information. Thank you.

Medication

Have you previously had side effects with retinoids, clindamycin or benzoly peroxide (e.g., severe irritation, allergy)?(Required)

Yes

No

A pharmacist will be in touch with you to discuss if this treatment is suitable for you.

Are you taking any medicines, herbal products, or supplements?(Required)

Yes

No

Please detail what you are taking, letting us know how often and dosing where possible:(Required)

Consent & Declarations

Do you consent to us sharing the details of your supply with your regular GP in order to improve your continuity of care?(Required)

Yes

No

Please be aware of the importance for your GP to be informed of all of the medication you are taking to ensure that you receive the best care. Please only choose "No" if you are certain you do not wish for us to inform your GP

Please provide Doctor Details(Required)

Enter Surgery Name(Required)

Please provide Doctor Details(Required)

Please provide Doctor Details(Required)

Please provide Doctor Details(Required)

Please provide Doctor Details(Required)

Concent(Required)

I understand these treatments may cause redness/dryness/peeling at first; I’ll start gently (e.g., alternate nights if needed). I understand they can increase sun sensitivity; I’ll avoid sunbeds and use sunscreen if exposed.(Required)

Concent(Required)

Improvement usually takes 4–8 weeks; I won’t stop early unless severe irritation occurs. I’ll stop and seek advice if severe irritation or allergy develops.(Required)

Consent(Required)

I agree to use this medication for 12 weeks and seek review if further treatment is needed.(Required)

Concent(Required)

I understand the prescriber makes the final decision and I consent for them to access my National Care Record.(Required)

Consent(Required)

This treatment is for my personal use; my answers are true and complete.(Required)

Complete our 2 minute
questionnaire

We're almost done!

To find a treatment suitable for you, we just need you to answer a few questions.

Hussain Member
Superintendent Pharmacist

Confidential & Secure

We will review your details in complete confidence

Medication will be delivered in plain unlabelled packaging

Your order will appear on your statement as "My Chemist Plus"

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Pharmaceutical
Council

General Pharmaceutical Council

My Chemist Plus is registered and regulated by the GPhC, who are the official body that regulates and inspects all pharmacies in the UK.

LegitScript certification

My Chemist Plus is certified by Legit Script, who monitors online pharmacies to evaluate compliance.

Need help?

If you need help with this medical assessment, contact our helpline:

or email us

[email protected]

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Unity House, Fletcher Street, Bolton BL3 6NE Company number: 15904237

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