In the past, prescription skincare required an in-person dermatology appointment, often followed by long pharmacy lines and complicated instructions. Today, a new wave of prescription skincare startups is changing that. With sleek websites, personalized regimens, and teleconsultations, companies like Curology, Apostrophe, and Musely are delivering prescription-grade treatments directly to consumers’ doors. These startups promise convenience, customization, and rapid results but as they gain popularity, a critical question arises: are dermatologists being bypassed in the process?
The Appeal of Direct-to-Consumer Skincare
The appeal of these startups is obvious. With just a few clicks, users upload photos of their skin, answer an online questionnaire, and receive a custom-blended prescription cream formulated by a healthcare provider. The entire process is virtual, affordable, and fast.
Key benefits include:
- Accessibility: No waiting weeks for a dermatology appointment
- Affordability: Many services start as low as $20–$30/month
- Convenience: Medications are shipped directly to the customer
- Customization: Formulations are often tailored to acne, rosacea, melasma, or anti-aging concerns
This model resonates strongly with younger, tech-savvy consumers looking for instant, personalized solutions.
What These Startups Offer
Most prescription skincare startups follow a similar model:
- Online Skin Assessment: Users answer questions about their skin concerns and history.
- Photo Upload: Customers submit selfies to help providers assess their skin.
- Telehealth Review: A licensed medical provider (usually a nurse practitioner, PA, or dermatologist) reviews the case and prescribes a topical formulation.
- Custom Formulation: Common ingredients include tretinoin, niacinamide, clindamycin, hydroquinone, and azelaic acid.
- Ongoing Support: Follow-ups are often via messaging or app-based support.
Popular platforms include:
- Curology – Targets acne and anti-aging
- Apostrophe – Focuses on acne, melasma, and rosacea
- Musely – Offers dark spot and anti-aging treatments, including hydroquinone
- Nurx – Combines skincare with birth control and STI testing
Are Dermatologists Being Sidelined?
While these platforms may offer a practical alternative to traditional care, some dermatologists are raising concerns:
1. Quality of Diagnosis
Dermatologists spend years training to differentiate between subtle skin conditions. A photo and a questionnaire may not capture the nuances of conditions like lupus, skin cancer, or drug-induced rashes.
“AI or a 10-minute online intake can’t replace a full skin exam,” says Dr. Mona Gohara, a board-certified dermatologist and educator.
2. Oversimplification
Prescription skincare startups often reduce treatment to cosmetic concerns, ignoring underlying causes or systemic factors. For example, persistent acne may be a sign of hormonal imbalance or polycystic ovary syndrome (PCOS), which requires more than topical care.
3. Lack of Long-Term Management
These services are usually subscription-based and optimized for scalability, not continuity. Follow-up care, lab work, and holistic treatment plans may be lacking.
4. Commercial Overreach
Critics argue that these startups blur the line between medicine and marketing, potentially leading to overprescription or misuse of potent ingredients like tretinoin or hydroquinone without adequate monitoring.
The Dermatologist’s Role Is Evolving
Despite concerns, many dermatologists see opportunity rather than competition. Teledermatology has grown exponentially, and some providers are embracing hybrid models that blend traditional in-office care with digital outreach. Others have joined or consulted for these startups, helping to improve quality and safety.
Board-certified dermatologists are still the gold standard for diagnosing complex skin conditions, performing biopsies, and managing autoimmune or cancer-related skin disorders. For cosmetic and chronic issues, however, prescription skincare startups are filling an undeniable gap.
Regulation and Medical Oversight
Most startups comply with telemedicine laws and use licensed healthcare providers. However, the level of dermatology expertise varies. Some states require initial video consults, while others allow asynchronous (store-and-forward) models where providers review information later.
The American Academy of Dermatology (AAD) emphasizes that any teledermatology service should include:
- Thorough medical history
- Clear provider credentials
- Ability to escalate care when needed
- Transparency about risks and benefits
What Should Patients Consider?
Consumers interested in using these platforms should:
- Check provider credentials and whether a board-certified dermatologist is involved
- Understand ingredient risks, especially with tretinoin, clindamycin, or hydroquinone
- Look for follow-up support and escalation plans
- Know when to seek in-person care for persistent, painful, or suspicious skin issues
Prescription skincare startups are changing the way people access dermatologic care offering speed, affordability, and personalization that appeal to a digital-first generation. While they may not replace the comprehensive care of a dermatologist, they are helping bridge gaps in access and convenience. The future likely lies in collaboration, where dermatologists help guide the growth of these platforms to ensure safety, efficacy, and patient-centered care.
References
- Gohara, M. (2022). The limits of online skincare: Why dermatologists still matter. Dermatology Times. https://www.dermatologytimes.com/
- American Academy of Dermatology. (2021). Teledermatology position statement. https://www.aad.org
- Goldberg, D. J., & Alam, M. (2020). The rise of digital dermatology: A new era of virtual skin care. Journal of Drugs in Dermatology, 19(10), 1002–1005.
- Jancin, B. (2023). Direct-to-consumer dermatology: Revolution or risk? Medscape Dermatology. https://www.medscape.com
