Does Prescription Skin Care Really Work Better?


Sometimes prescription skincare products work better than over-the-counter (OTC) skincare products, and sometimes they don’t — it depends. For example, 2.5% benzoyl peroxide OTC FDA regulated “drug” will work better for acne than prescription topical antibiotic skin care products. Because the acne-causing bacterium C. acnes is resistant to antibiotics, but still sensitive to benzoyl peroxide.

Also, prescription tretinoin may be more effective than OTC retinol creams for anti-aging collagen formation. But we are not sure. Rigorous studies were conducted on the original Retin-A formulation of tretinoin to prove efficacy, but not on retinol products because studies are expensive; also because OTC retinol is not a patentable drug.

Cosmeceuticals are just as effective as prescription skin care


The same dilemma applies to other ingredients like vitamin C and other antioxidants.

We won’t see good studies proving or disproving the effectiveness of many ingredients. This is due to the financial reality of study costs, particularly with drug claims for ingredients and products that cannot be protected by a patent. – Dermatologist Dr. Bailey

I’ve heard that the cost of taking a patented product through the FDA-mandated study process to make a drug claim is at least $19 million and possibly even billions! As a doctor, I know there are good OTC skin care products, including cosmeceuticals, that can help improve skin conditions. Because of the cost of skipping the FDA hoop, they are underinvested and rigorously tested so they can make an FDA-approved “drug claim.” Some of these are great products to include in a robust skincare routine because they can “fight,” “help,” and “improve the appearance” of your skin concerns without claiming to “treat” them like a drug.


Results on your skin are what matters

prescription skin care really works better

To determine the effectiveness of a prescription or non-prescription product, I combine scientific knowledge, clinical experience, and observation to decide if a product is of benefit.

  1. I use what I know about the physiology of the skin problem first.
  2. Then I look for useful products and/or ingredients based on my scientific understanding.
  3. I try a product on myself.
  4. I then ask staff and interested patients to try them out.
  5. We monitor whether the product appears to work based on physical exams and user feedback.
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It depends on how research is done

Do research studies claim to work on real live human skin or on a cell culture in a petri dish?

Are prescription skin care products better, check out the research

They are not the same! A really important aspect of product efficacy and claims is the difference between in vitro results and product use claims.


Do the seemingly impressive in vitro results (ie in the lab, but not on a living organism) reported from a laboratory study really mean that a product will work on your skin?

The answer is mostly no! A solution of cells or chemical reactions swirling in a test tube is nothing like your skin.

Just because an ingredient does something wonderful in a test tube doesn’t mean the ingredient will work on your skin. – dr Bailey


Mixing the ingredient with others in a product formulation is one reason. The other is that your skin has a stubborn barrier and complex physiology. That’s why I test products on enthusiastic people.

Does stronger prescription strength always mean better?

Another example of an ingredient that shows OTC and prescription variability is hydroquinone. We know that prescription strengths of 4% and higher work better than the OTC concentration of 2% for lightening hyperpigmentation. It’s also more effective than the over-the-counter botanical pigment lighteners.

Over-the-counter hydroquinone can work just as well as prescription if it is not oxidized

But hydroquinone quickly breaks down through a process called oxidation. An amber hydroquinone product is oxidized and will not work. However, hydroquinone is the most effective pigment lightening ingredient. A good OTC hydroquinone product at 2% in a product that has not been oxidized will help correct uneven skin hyperpigmentation. The Rx Strength is more effective, but not when oxidized.

High potency AHAs went by prescription and are now OTC

One of my favorite products and ingredients is the Alpha Hydroxy Acids (AHA). I’ve been using them on patients’ skin and my own since the 1980’s. AHAs are OTC, but the very first good product was a 12% lactic acid that required a prescription. The same 12% lactic acid cream is now available over the counter.

non-prescription professional glycolic acid face cream

AHA products are widely available in many different forms. Potency varies depending on the AHA (there are different types) and the strength and pH of the product. This means that the formulation of a product matters. AHAs that work well must be formulated by good cosmetic chemists with an acidic pH and a free acid content above 10%. All of my glycolic acid products are formulated this way; They are stronger and more effective than the original prescription AHA lactic acid product.

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non-prescription aha body lotion

AHAs are a workhorse for non-prescription anti-aging skincare, clogged pores, and acne. They can even be used as a body lotion to keep your body’s large skin surface soft, supple and youthful. Trust me – my 63 year old skin would look completely different without AHAs! When building your complete skincare routine, there are so many considerations to take into account.

OTC dandruff shampoos can work just as well as prescription ones

non-prescription dandruff shampoo that works just as well as prescription

Pyrithione Zinc and Selenium Sulfide Shampoos are proven, effective OTC dandruff shampoos. Rx options include Loprox. Ketoconazole started out by prescription and now it’s OTC too.

Interestingly, with a prescription product, the primary source of money for the purchase comes from your own health insurance. The consumer pays the cost of a product that is not covered in their plan or has not met their deductible. You also pay part of the cost as a co-pay. If a product does not require a prescription, the consumer always pays out of pocket.

When deciding between prescription and non-prescription skin care products, price is a factor.

Do you have easy access to a dermatologist for prescription skin care? Do you have good prescription insurance? What is your total skincare budget? Prescription drug prices have become prohibitive for many, even with health insurance. Having practiced dermatology for 35 years and obsessively studying skincare science, I know which OTC products will produce results. My goal is to help my readers build their own purposeful and scientifically correct complete skincare routine to meet their goals, stay on budget, and use the best OTC skincare products to achieve it.

non-prescription skin care that works just as well as prescription


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