Picture this scenario: Your dermatologist prescribes you a generic topical cream, maybe for acne, eczema, or just purely skin-brightening purposes. Yet when you show up to the pharmacy to fill said prescription, instead of costing $15 or so, the pharmacist tells you it's going to be around $1,000. Yes, just for one tube of cream and yes, even with your insurance. Or, maybe you're able to fill it with the $35 co-pay on your insurance plan, but the pharmacy still bills your insurance company $1,000, which may cause future co-pays or out-of- pocket expenses to increase exponentially.
For a plethora of reasons, the cost of generic, basic dermatological medications keep soaring. This is precisely what prompted Dhaval Bhanusali, a board- certified dermatologist in New York City, to create Skin Medicinals, an online platform that sells medications for common skin conditions and concerns, like rosacea and scarring, for under $60.
"It is becoming more and more challenging to create treatment plans for my patients because I never know how much the medications are going to cost," says Kristina Goldenberg, a board-certified dermatologist in New York City, who has no affiliation with Bhanusali or Skin Medicinals. "I now preemptively formulate plan A, plan B, and plan C for every acne patient that I treat, [and] this is secondary to multiple phone calls from pharmacies and/or patients reporting that the medications I prescribed initially are too expensive."
Realizing the increasing ridiculousness of the situation, Bhanusali founded Skin Medicinals in 2019. Here's the premise: Dermatologists can select specific generic ingredients to mix together to make a personalized cream — called a compounded medication — for a patient. Then, they send the prescription through the Skin Medicinals portal, and a compounding pharmacy creates the personalized cream and ships it straight to the patient's front door. All of this is done for a flat-rate fee without involving insurance.
"The goal, at its core, is just to give patients access to medications and products at a reasonable price," Bhanusali tells ishonest. "It's led to some incredible results in everything from acne to melasma to rosacea, and [it is] quickly becoming a whole new paradigm for treating our patients."
Everything is out of pocket, yes, but the prices are more affordable than you'd usually find at a regular pharmacy through your insurance. Most generic steroids, for example, cost somewhere in the $20 to $30 range; acne compounds are generally between $35 to 40; skin-smoothing and brightening compounds can cost up to $55. Note that these prices are general and apply to generic topicals — brand name creams will always be more costly, Goldenberg says, even though they are formulated with the same ingredients.
"We can essentially create a prescription product with strengths of medications beyond anything you see over-the-counter," Bhanusali says. "Per our understanding, there isn't anything in the beauty world that is similar and offers the customizability of strengths and diversity of ingredients."
For example, you can start with a tretinoin base (a retinoid medication) and formulate it specifically to a strength that the patient's skin can tolerate. Then, the dermatologist can add supplemental ingredients based on skin concerns, such as hyaluronic acid for hydration, or vitamins C and E for antioxidant protection.
The only catch: You do have to consult with a board-certified dermatologist to get your hands on a product – the platform provides a directory of prescribing physicians, almost all of which are currently offering telemedicine appointments during the pandemic, from the comfort and safety of your own living room.
But even though this isn't as convenient as simply ordering a moisturizer online, it's always a smart idea to consult a professional before starting a new skin-care regimen (or even introducing a new ingredient, such as retinol). Besides, as Bhanusali said, dermatologists can offer you access to much stronger ingredients anyway.
If you're interested in trying it out, the platform now has a feature to search for, find, and make appointments with participating dermatologists across the country, many of which participate in telemedicine — there are currently around 3.200 dermatologists registered with Skin Medicinals nationwide, and counting. However, any board-certified dermatologist can prescribe through the system as long as they register on the website. Find out more at skinmedicinals.com.
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