If you're looking to improve the look of your skin, you're not alone. People of all ages want to have healthy, glowing skin! Whether you're looking to address fine lines and wrinkles, combat acne or rosacea, or simply improve the overall appearance of your skin, there is no shortage of skincare products available to help you achieve your skincare goals. 

While over-the-counter (OTC) options can be an effective starting point for many people, it's important to recognize that they may not always provide the level of targeted treatment needed to fully address certain skin conditions. This is where prescription skincare comes into play. 

By offering a more customized and precise approach to skincare, prescription products have the potential to deliver more significant and lasting results than their OTC counterparts. Here, we’ll explore the differences between prescription and OTC skincare and provide you with the information you need to determine which type of product is best suited to your skin's unique needs.

What is prescription skincare?

Prescription skincare

Under the Federal Food, Drug, and Cosmetic Act, cosmetics are classified as substances that are intended to be applied to the body for various purposes, such as cleansing or altering appearance.¹ Conversely, drugs are substances that are used to treat, diagnose, prevent, mitigate, or affect the body's structure or function.²

In 1984, Albert Kligman, MD, PhD, coined the term "cosmeceutical" to refer to products that offer therapeutic benefits beyond what cosmetics can provide.³ These products may have clinical capabilities to repair and rejuvenate skin that has been damaged by exposure to sunlight. 

It's worth noting that cosmeceuticals often contain active ingredients such as retinoids, alpha hydroxy acids, or peptides that have been scientifically proven to improve skin health. These ingredients can be found in varying concentrations and some may not be available in over-the-counter cosmetic products. Therefore, they require a prescription from a dermatologist or other medical professional. Understanding the distinction between cosmeceuticals, cosmetics, and drugs is essential in choosing the right products to improve your skin's health and appearance.⁴

Prescription vs OTC

To ensure safety and efficacy, certain skincare products requiring a prescription undergo a rigorous approval process by the FDA. Prescriptive skin treatments can treat a variety of conditions such as acne or signs of aging. 

On the other hand, cosmetics are OTC products mostly created by the skincare industry and are not subject to the same level of scrutiny. However, the FDA's Center for Food Safety and Applied Nutrition oversees cosmetics and establishes safety and labeling guidelines.

Cosmetics are generally not designed to alter the structure of the skin, whereas cosmeceuticals can affect the appearance of the skin. Cosmeceuticals exist in a gray area between drugs and cosmetics.⁵

What is prescription skincare commonly used for?

Prescription skincare is a medical intervention used to manage several skin conditions, such as acne, rosacea, psoriasis, eczema, and hyperpigmentation. These products contain active ingredients that specifically target skin concerns like inflammation reduction, regulation of oil production, stimulation of collagen production, and promotion of skin cell turnover. 

Prescription skincare can enhance the skin's overall appearance and texture while helping prevent future skin damage. It is essential to follow the guidance of a healthcare professional while using prescription skincare since these products can have side effects and may interact with other medications.⁶

What kinds of prescription skin care are there? 

Tretinoin

Tretinoin is a retinoid, or vitamin A derivative, and has been used as a topical treatment for acne for over fifty years. Initially, dermatology providers recognized tretinoin for its ability to reduce the buildup of dead skin cells and oil that can clog pores and lead to breakouts—but in recent years, they’ve also noted its anti-inflammatory properties. 

Tretinoin is often combined with antibacterial agents, such as erythromycin, benzoyl peroxide, and clindamycin, to form topical combination treatments for acne. The combination treatment of tretinoin with clindamycin in particular, which includes antibacterial and anti-inflammatory properties, has been shown to be an effective therapy for the various stages of acne.⁷ Consider using an acne-fighting face wash (like Curology’s Acne Cleanser) alongside prescription skincare for optimal results. 

Clindamycin

Clindamycin is an antibiotic recommended as a first-line therapy in the acute inflammatory phase of acne, according to several treatment guidelines and expert consensus documents. 

Clindamycin can lead to resistance in P. acnes as well as other skin bacteria when used long-term as monotherapy. Studies have shown that clindamycin-resistant strains of S. epidermidis, a common bacterium found on the skin, can emerge after treatment with this antibiotic. Antibiotic resistance occurs when bacteria develop the ability to survive and grow in the presence of antibiotics, rendering the antibiotics ineffective.⁸ For this reason, to reduce the emergence of antibiotic resistance, it is recommended to use topical clindamycin in combination with another antimicrobial agent.

Azelaic acid

Topical azelaic acid is available in varying strengths, some by prescription only. It is typically used to treat acne vulgaris, melasma, and rosacea. For hyperpigmentation, it works by lightening the skin by reducing the production of melanin, a pigment that gives color to your skin. This is achieved by blocking the activity of an enzyme called tyrosinase, which is involved in the production of melanin.⁹

Metronidazole

Topical metronidazole has antimicrobial properties and is used as a treatment for rosacea. Rosacea is a skin condition that causes redness, visible blood vessels, and acne-like bumps on the face. When applied topically, metronidazole is generally well-tolerated, with only mild to moderate side effects such as stinging, dryness, burning, or itching. It is considered safe and effective for treating rosacea when used as directed by a healthcare professional.¹⁰

Finding the best skincare for your needs

Prescription skincare offers a more targeted approach to treating various skin conditions compared to over-the-counter products. In fact, clinical studies have demonstrated that prescription skincare can effectively modify the skin's appearance. 

There are various types of prescription skincare available, each with a specific purpose in treating conditions such as acne, rosacea, and hyperpigmentation. It is important to use these products under the guidance of a healthcare professional, as they can have side effects and may interact with other medications. 

With the help of a healthcare professional, prescription skincare can help improve the overall appearance and texture of the skin while protecting the health of your skin. That’s where Curology comes in handy. Our team of licensed dermatology providers can not only prescribe you a personalized formula to target your biggest skin concerns, but they can also recommend a full skincare routine to help get a healthier complexion.

Get your personalized skincare routine with Curology

Get your personalized skincare routine with Curology

Start your skin quiz

Start your 30-day trial* today by snapping a few selfies and taking a short quiz about your skin. If Curology is right for you, a dermatology provider in your state will help you along on your skincare journey.

P.S. We did the homework so you don't have to:

1. U.S. Food & Drug Administration. Is It a Cosmetic, a Drug, or Both? (Or Is It Soap?). (2022, February 25).

2. U.S. Food & Drug Administration. Is It a Cosmetic, a Drug, or Both? (Or Is It Soap?). Ibid.

3. Pandey, A., et al. Cosmeceuticals. StatPearls. (2022, August 8).

4. Pandey, A., et al. Cosmeceuticals. StatPearls. Ibid.

5. Pandey, A., et al. Cosmeceuticals. StatPearls. Ibid.

6. Pandey, A., et al. Cosmeceuticals. StatPearls. Ibid.

7. Schmidt, N. and Gans, E.H. Tretinoin: A Review of Its Anti-inflammatory Properties in the Treatment of Acne. The Journal of Clinical and Aesthetic Dermatology. (November 2011). 

8. Xu, H. and Li, H. Acne, the Skin Microbiome, and Antibiotic Treatment. American Journal of Clinical Dermatology. (June 2019).

9. Nazzaro-Porro, M. Azelaic acid. Journal of the American Academy of Dermatology. (December 1987). 

10. McClellan, K.J. and Noble, S. Topical Metronidazole. American Journal of Clinical Dermatology. (2012, August 22). 

Erin Pate is a board-certified Family Nurse Practitioner at Curology. She earned her Masters of Science in Nursing at Florida Atlantic University in Boca Raton, FL.

*Cancel at any time. Subject to consultation. Results may vary. 

Written by

Curology Team

Medically reviewed by

Erin Pate, NP-C