Get a Prescription for Acne

Step 1 of 3

Name *

First

Last

Date of Birth *

Email *

Address *

Select Pharmacy to where prescriptions should be sent. Select "other" if you can't find your pharmacy *

2. Have you ever had acne in the past? *

3. Which option best describes your skin condition? *

Limited to the face with black and/or whiteheads and only a few inflamed pimples.
Affects face, shoulders and back with an increased number of inflammatory pimples and pustules.
Widespread acne with whiteheads, blackheads, pimples and inflammation, affecting face, shoulders, back and other areas of the body.
Widespread acne as above, as well as scarring or pitting.

5. How would you describe your skin type? *

6. Please confirm your gender at birth - it's really important to help us find the right acne treatment for you. *