Does it feel like you’ve tried every best-selling skincare product around? There’s the cleanser your best friend credits with banishing her breakouts, the moisturiser made using NASA tech, the serum that was meant to turn back the clock and countless more, we’re sure.

And yet, despite these impressive claims and studies proving their efficacy, have you found they’ve done little to give you the complexion of your dreams? Cue prescription skincare, which unlike so many off-the-shelf products, are medically proven to work.

But are they truly better for you, and if they are, why aren’t we all on some sort of prescription skincare routine? Read on to discover what our EV experts had to say, their answers might surprise you…

How is prescription skincare different?

Unlike the skincare we pick up in shops, prescription skincare is only available via a certified medical professional. In short, prescription skincare treatments are considered drugs.

“A drug can be defined as a product that is used in treatment or prevention of disease that acts at a cellular level—meaning it affects the structure or function of a cell. They are extensively researched and highly regulated by authorities,” explains Dr Sandra Gamper, Aesthetic Doctor at Miriderma Skin Health Clinic. While non-prescription skincare products certainly can (and do) improve the skin’s appearance, they cannot legally affect cellular action.

Before receiving prescription skincare treatments, you will typically have to undergo a full consultation with a medical professional who will advise a specific course of treatment, unique to you and your skin. Throughout the course of treatment, you will also be required to visit your prescribing professional for check-ups and tests, if relevant.
 

Are prescription skin treatments more effective?

This is where things start to get a little complex. The answer is both yes and no. “If your concern is something that links to a medical diagnosis, then yes, prescription treatments will be more effective. However, if you are simply aiming to maintain skin health, then not necessarily,” says Gamper.

If we are talking about proven efficacy for a specific result, prescription skincare is more effective. “Prescription skin treatments have to have evidence that prove the ingredients will produce a specific outcome,” adds Gamper. However, such outcomes are only going to prove effective if there is something that needs treating in the skin.

Non-prescription skincare is still regarded as very effective for other skin concerns. “Often, practitioners use a combination of prescription and non-prescription items for patients to achieve results. There are some fantastic active ingredients on the market that don’t need a prescription,” reveals Amanda Wilson, Independent Nurse Prescriber at Dr Nestor’s Medical Cosmetic Centre. One of the most important of these is sun protection, “it should be used by all patients in order to protect the skin from damage,” adds Wilson.

Should I swap my skincare for prescription treatments?

If you are dealing with a condition of the skin like acne, rosacea, pigmentation, or scarring, all of which require cellular change for long-term results, then prescription skincare is likely for you. However, it’s worth knowing that, more so than off-the-shelf skincare, prescription treatments risk skin upset.

Dr Gamper explains, “prescription skincare comes with the risk of side effects and may not be suitable for everyone – a factor that needs to be considered carefully by your prescriber. On the other hand, off-the-shelf options have lower risks and are generally safer for the wider population.”

If you’re concerned that you do have a skin issue that requires a medical grade solution, below is everything you need to know about the most commonly prescribed skin treatments...

Isotretinoin 

If you’ve ever had severe acne, there’s a high chance you will have heard of isotretinoin before. Otherwise known as Roaccutane, this drug contains a form of vitamin A, retinoic acid, in oral form. It works by shrinking oil glands, dramatically reducing the amount of sebum created and in turn reducing breakouts.

“Roaccutane can only be initiated by a dermatologist and is considered the gold standard treatment for severe acne. However, the drug has several severe side effects which need to be considered, and patients must be carefully monitored,” says Gamper.

Common side effects of Roaccutane include dry skin, eyes, nose, and lips, skin irritation, dry mouth, headaches, and muscle and joint pain. Rarer side effects include severe mood changes and mental health problems.

Tretinoin

Within the same family as isotretinoin, retinoid tretinoin is a topical form of retinoic acid. “Ever-popular, tretinoin treats specific skin cell receptors and helps to repair photo-damaged skin, improve growth and differentiation of skin cells, has anti-inflammatory actions, and helps to suppress oil production. It also has remarkable skin ageing benefits,” reveals Dr Gamper.

Side effects from tretinoin might include skin irritation and redness, but tolerability can be built up over time.

Spironolactone

Compared to other prescription skin treatments, spironolactone is a relatively new drug on the scene. “It was traditionally a medicine used to treat high blood pressure, however, it is now being used more by dermatologists for the treatment of oily skin and acne,” shares Gamper.

Spironolactone works against oil production by harnessing its anti-androgen properties. “It stops the conversion of testosterone into its active form (to keep oil production at a 'normal' rate),” adds Gamper.

While results from spironolactone are widely regarded to be successful in the treatment of acne, the NHS doesn’t regard it as a licensed drug for acne treatment, meaning it can be difficult to get hold of via your GP (there are a few caveats under which the NHS may prescribe). However, spironolactone is commonly available via private dermatologists.

Hydroquinone

When it comes to reducing skin pigmentation, topical hydroquinone is considered the go-to treatment. “It works by suppressing the cells responsible for making pigment. Patients can expect to see improvements in six to eight weeks if compliance with the treatment regimen is maintained,” says Wilson.

It is, however, worth noting that hydroquinone can come with drawbacks – namely irritation and sensitivity. Turns out some people are actually allergic to the stuff, while others may end up with irritant contact dermatitis, and across the board skin becomes more sensitive to the sun. There is also, while rare, another side effect to watch out for – ochronosis, a condition where irreversible skin darkening occurs.

This is particularly true for those with brown and Black skin, where in fact, “hydroquinone may not be suitable at all, making non-prescription alternatives like cysteamine, liquorice root, and alpha arbutin safer options,” adds Gamper.

Benzoyl Peroxide

Although widely available in the U.S., benzoyl peroxide is considered a drug in this country, meaning higher doses must be prescribed by a medical professional. Popular in the treatment of acne, it can be used long-term to target acne-causing bacteria.

“By reducing bacteria on the skin, benzoyl peroxide can reduce inflammation caused by acne, and when used in combination with acids, it can also help to reduce oil build up,” reveals Wilson.

In terms of side effects, much like most acne treatments, benzoyl peroxide risks being irritating and drying on the skin. It also has the ability to ‘bleach’ hair and clothes, so precautions should be taken when using it.