While there’s certainly a time and place for elixirs that are infused with the finest botanicals and flowers earth has to offer, there are several products that really shouldn’t be purchased at a drugstore — not because they aren’t good or even effective in addressing common concerns like aging or hyper pigmentation, but because the laws of medicine dictate they will never be as good as those you can purchase at your dermatologist or plastic surgeon’s office.
Tough love, I know, but if you’re going to spend $80 on a cream or peeling system, wouldn’t you rather it be the best your money can buy?
With that said, there are other wonderful skin care products that can and should be purchased at your neighborhood drugstore or beauty supply store. Knowing when to save up for that trip to the doc and when to splurge at Sephora is a key component in achieving the best skin of your life.
Products that should only be obtained via prescription
1. Retin-A: You may think you’ve been using a Retin-A cream you bought for $40 at a drugstore in order to help combat wrinkles and fine lines, but the unfortunate truth is that you’re actually using a far less potent ingredient called retinol. "Retinols are products that are available OTC but are not as strong,” says Dr. Michael J. Brown, a board certified plastic surgeon at The Loudoun Center for Plastic Surgery. "The retinols are compounds that are changed when applied to skin and are converted into Retin-A once absorbed by the body. This conversion (chemical reaction) makes them more like a cap gun amount versus the Rx strength of the vitamin A (Retin-A).”
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Dr. Jill Waibel, director of Miami Dermatology & Laser Institute, says there's really no comparison between a doctor-prescribed Retin-A and all other forms of the product. "Frankly, comparing retinol, retinoids and Retin-A is like trying to compare a puddle, a lake and an ocean — the differences are vast," Waibel says. "Retin-A is scientifically proven to decrease acne and wrinkles, while retinol is a watered-down version that just doesn’t hold up, which is what is available at drugstores. While people can be turned off by the price of products at dermatologist’s office, it’s important to remember that with high cost comes the best results. These products are expensive to formulate because it’s all about being able to deliver the active ingredients to the right place in the skin, and drugstore products can’t do that as well as a well-developed, clinically-researched products."
2. Vitamin C serums/creams: Vitamin C can make your skin glow, boost collagen and act as a line of defense against fine lines and wrinkles, but you’ll get a lot more out of everyone’s favorite vitamin if you splurge on a higher quality product or ask your doctor for a recommendation. "The vitamin C products are probably the biggest waste because most are oxidized once the product is opened and they lose their effectiveness very quickly,” Brown says. "So the cheaper vitamin C (less stable) products available OTC are something I would not recommend buying. The stabilized versions are more expensive.”
Speaking from personal experience, SkinCeuticals C E Ferulic may be pricier, but it’s stabilized thanks to the addition of ferulic acid and vitamin E — and worth every penny.
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3. Products containing skin lightening ingredients: First of all, you need a medical degree to properly self-diagnose the cause of your brown spots or skin discolorations (which you should get checked out purely for health reasons anyway). Second, do you honestly want to try and figure out what (relatively small) percentage of OTC hydroquinone you should apply to your skin when a pro can actually prescribe a cream that works? Dr. Tsippora Shainhouse, a board-certified dermatologist in Beverly Hills, says OTC products like skin lighteners will not only be less effective and take longer to see results, but can contain inactive ingredients that make it more irritating for some people.
"With more potent products, you want to be able to examine and counsel the patient, to determine their skin goals and to explain how to properly use the products and prepare the patient for any potential side effects," Shainhouse says. "Often skin care products do best when they are incorporated into a regular skincare regimen, that can be created together with your dermatologist."
4. Products used to treat eczema, rosacea or acne: Chances are, an OTC cream isn't going to effectively address a more serious case of skin irritation like eczema or rosacea or a stubborn case of consistent hormonal acne, says Dr. Sonia Batra at Batra Medical, Surgical, and Cosmetic Dermatology. Know when to stop treating your skin issues as aesthetic ones and seek medical help. "At a dermatologist's office, there will be more oversight, instructions and follow up for the products and they can be coordinated better with any treatments like lasers or peels performed in the office or prescription-strength products prescribed by the doctor," Batra says.
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But there are at least two important skin care products that Waibel says you can buy anywhere — a gentle cleanser (she recommends Cetaphil Gentle Cleaner), which she says doesn't contain many active ingredients that will irritate skin and can be pulled straight from a drugstore shelf, and your daily moisturizer. "A moisturizer’s purpose is to moisturize your skin and there aren’t any products that reign over the other brands or types," Waibel says. "One of my favorite moisturizers is Cetaphil Moisturizing Cream. This helps soothe moisturize the skin while preventing further dryness."
If you suffer from acne-prone skin and you prefer to treat your condition without a prescription strength product like Accutane, Shainhouse says OTC soaps and acne washes are fine, as are sunscreens with SPF 30 or higher and serums that simply feel great on your skin.
At the end of the day, whether you choose to ask your doctor for a prescription depends on how determined you are to improve a definitive skin concern. "If you are looking for specific active effects from your skincare products, including anti-aging, skin lightening and others, consider office-dispensed versions with scientifically-proven and higher concentrations of active ingredients," she says.