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Specialist systemic dermatology care

Acitretin Treatment in London

Acitretin is a specialist oral retinoid used for severe psoriasis and keratinisation disorders. At Skinhorizon Clinic in Maida Vale, treatment is planned carefully by a consultant dermatologist, with safety monitoring, blood tests, pregnancy prevention where relevant, and personalised follow-up.

Consultant-led
Reviewed by Dr Mohammad Ghazavi, Consultant Dermatologist.
CQC-registered clinic
Private dermatology care in Maida Vale, London.
Safety monitored
Blood tests, side-effect review and structured follow-up.
Central London access
Convenient for St John’s Wood, Paddington and West London.
Quick answer

What is acitretin?

Acitretin is a prescription oral retinoid, derived from vitamin A, used by dermatologists for severe psoriasis and disorders of keratinisation. It helps normalise skin cell growth and shedding, but it requires careful monitoring, liver and lipid blood tests, and strict pregnancy prevention for anyone who could become pregnant.

Acitretin at a glance

What is it? An oral retinoid prescribed for severe psoriasis and disorders of keratinisation.
Key indications Severe plaque psoriasis, pustular psoriasis, palmoplantar psoriasis, pityriasis rubra pilaris, ichthyoses and related conditions.
Who is it for? Adults needing systemic treatment who can commit to monitoring. It is not suitable during pregnancy or breastfeeding.
Why it matters It can be helpful when topicals or phototherapy are insufficient, especially for thick scaling or keratinisation disorders.
Monitoring Regular blood tests, side-effect review, contraception planning where relevant and tailored follow-up.
Appointments 7 days a week (subject to availability).
Editorial overview

Understanding acitretin

Acitretin is a prescription oral retinoid used by dermatologists to treat severe psoriasis and conditions where the outer skin layer grows and sheds abnormally. These are sometimes called keratinisation disorders.

By influencing how skin cells mature and separate, acitretin can help thin overly thick plaques, reduce scaling and improve skin comfort and function. Because it does not directly suppress the immune system, it can be a useful option for selected patients who do not suit some immunosuppressive treatments.

Dr Mohammad Ghazavi consultant dermatologist providing psoriasis and acitretin treatment advice at Skinhorizon Clinic London
Consultant dermatologist-led psoriasis and systemic treatment care at Skinhorizon Clinic, Maida Vale, London.

How acitretin works

Skin cell turnover

Normalising growth and shedding

Retinoids bind to receptors in skin cells and influence gene expression. In practical terms, acitretin helps slow excessive skin cell proliferation and encourages more orderly maturation.

Clinical effect

Reducing scale and thickness

Over weeks to months, thickened plaques may become thinner, scaling can reduce and painful fissures may heal, especially in conditions affecting the palms and soles.

When we consider acitretin

Severe plaque psoriasis

Especially thick, scaly plaques or palm and sole involvement that has not responded adequately to topical treatment.

Pustular psoriasis

Including selected cases of palmoplantar pustulosis, where retinoid-responsive patterns are present.

Keratinisation disorders

Including some forms of ichthyosis and pityriasis rubra pilaris.

Sometimes acitretin is used alone; in other cases it may be combined with other modalities in a planned sequence. Your consultant dermatologist will tailor this to your condition, skin type, medical history and goals.

Considering systemic treatment for severe psoriasis?

A consultant-led review can help decide whether acitretin, phototherapy, biologics or another treatment pathway is most appropriate for your skin and safety profile.

Suitability

Who is a good candidate?

Suitability is assessed case by case. Acitretin is generally considered for adults who need systemic treatment and can commit to regular monitoring and pregnancy prevention measures where relevant.

It is not suitable during pregnancy or breastfeeding, and is avoided in people with significant liver disease, persistently high blood lipids or poorly controlled alcohol intake. If pregnancy is planned in the near future, alternative options are usually more appropriate.

How treatment is started and monitored

Starting treatment

Low-dose, measured introduction

Treatment often starts with a modest dose, then adjusts gradually based on response, blood results and side-effects. Taking acitretin with a main meal improves absorption.

Pre-treatment checks

History and baseline blood tests

Before starting, we review medical history, medicines, supplements, alcohol intake and pregnancy plans. Baseline blood tests usually include liver function and lipid profile.

Ongoing safety

Regular follow-up

During treatment, we monitor liver enzymes, lipids, side-effects and treatment response. The dose may be adjusted or paused if needed.

Important safety information

Pregnancy prevention

Acitretin is highly teratogenic and must not be used in pregnancy. Effective contraception, scheduled pregnancy testing and a defined post-treatment avoidance period are essential for anyone who could become pregnant.

Alcohol and liver health

Alcohol can affect retinoid metabolism and liver safety. Your clinician will give clear guidance on alcohol avoidance during treatment and after stopping where relevant.

Vitamin A and retinoids

Do not take vitamin A supplements or other retinoid medicines while taking acitretin unless specifically advised by your prescribing clinician.

Blood donation

Blood donation is avoided during treatment and for a period after stopping, to prevent exposure in pregnant recipients.

Side-effects

Common side-effects and how we manage them

Dryness is the most common effect. Patients may notice dry lips, dry facial skin, flaking, dry eyes or mild nosebleeds. These symptoms are usually managed with bland moisturisers, lip balm, preservative-free lubricating eye drops and dose adjustment when needed.

Retinoids can raise blood lipids or liver enzymes in some patients. This is why regular blood tests and follow-up are an essential part of safe acitretin treatment.

Contact the clinic promptly if you develop severe persistent headache, visual changes, yellowing of the skin or eyes, dark urine, severe abdominal pain, profound mood change or symptoms that feel out of proportion.

Everyday practical tips

Take with food

Take your capsule with your main meal to support absorption.

Protect dry skin

Use bland moisturisers, lip balm and gentle cleansing to reduce dryness and irritation.

Use sun protection

Daily broad-spectrum sunscreen and shade habits help reduce sensitivity and protect against sun damage.

Treatment choice

Acitretin vs other systemic options

Each systemic option for severe skin disease has a different balance of benefits and risks. Compared with immunosuppressants and biologics, acitretin does not broadly suppress immunity, which can be helpful for selected patients.

However, acitretin requires meticulous pregnancy prevention and is not suitable for anyone planning pregnancy in the near future. We discuss the relative pros and cons openly, including speed of response, route of treatment, monitoring and long-term goals.

Timelines

Results and timelines

In psoriasis and keratinisation disorders, visible improvement usually develops over weeks to a few months. Thick plaques may soften, scale may reduce and fissures may heal.

Some patients maintain improvement on a low dose; others complete a finite course and transition to maintenance with topical treatments, skincare and lifestyle measures.

Why choose Skinhorizon Clinic?

Consultant dermatologist-led care

Your treatment is reviewed by Dr Mohammad Ghazavi, Consultant Dermatologist, with careful attention to diagnosis, monitoring, safety and long-term control.

CQC-registered private clinic

Skinhorizon Clinic provides private dermatology care in Maida Vale, London, convenient for St John’s Wood, Paddington, West London and Central London.

Structured systemic treatment pathway

Our acitretin pathway includes start-low titration, blood test monitoring, clear education, proactive dry-skin support and personalised follow-up.

Your first visit — what to expect

Assessment

Review diagnosis, severity, previous treatments, medical history and treatment goals.

Safety checks

Discuss blood tests, pregnancy prevention where relevant, medication interactions and alcohol guidance.

Treatment plan

Agree dose, skincare support, monitoring schedule and realistic treatment timelines.

Follow-up

Review progress, side-effects, blood results and adjust treatment safely.

Reviewed by

Dr Mohammad Ghazavi

Consultant Dermatologist

Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ.

Last reviewed:

Frequently asked questions

What conditions does acitretin treat?
Acitretin is mainly used for severe psoriasis, including thick plaque and pustular types, and disorders of keratinisation such as some ichthyoses and pityriasis rubra pilaris.
How long before I see results?
Dryness may appear within the first weeks. Improvement in scaling and thickness usually develops over several weeks and may continue for months.
Can I drink alcohol while taking acitretin?
You will receive personalised advice from your clinician. Where advised, avoiding alcohol during treatment and for a period after stopping supports liver health and reduces safety risks.
Can I take vitamin A or other retinoids at the same time?
No. Vitamin A supplements and other retinoid medicines should be avoided while taking acitretin unless specifically advised by your prescribing clinician.
Is pregnancy allowed on acitretin?
No. Acitretin is highly teratogenic and must not be used in pregnancy. Effective contraception, scheduled pregnancy tests and a defined post-treatment avoidance period are essential for anyone who could become pregnant.
What tests are needed?
Blood tests for liver function and lipids are usually required before starting and at intervals during treatment. Additional tests may be arranged depending on your medical history.
Can I donate blood?
Blood donation is avoided during treatment and for a period after stopping, to prevent exposure in pregnant recipients.
What if I’m planning a pregnancy soon?
Acitretin would usually not be appropriate if pregnancy is planned in the near future. Your clinician can discuss alternative psoriasis treatments that align better with family-planning timelines.

Take the first step towards calmer, healthier skin

A structured consultant-led acitretin plan can help improve severe psoriasis or keratinisation disorders while keeping safety and monitoring central.

Disclaimer: This information is for general education only and does not replace personalised medical advice. Acitretin is a prescription-only medicine and requires individual consultant assessment, safety checks and monitoring.
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