What Makes Prescription Products Different?
Let's start with the basics. First off, prescription products are considered "drugs" because they are designed to treat medical conditions like acne, dark spots, and sun damage. Over-the-counter drugs do exist, but prescriptions can only be prescribed by a medical professional and can only be dispensed by a pharmacy. "For example, we have tretinoin, hydroquinone, and Latisse in our office, but a person must be seen first by myself or my assistant in order to get these treatments," explains Samolitis.
Prescription products also have to pass through a lot of red tape before they become available to the public. "When a drug is approved by the FDA, it must pass several phases of clinical trials determining safety first and then, efficacy," Samolitis says. This amount of research is part of what determines the often high price of prescription goods.
"These trials usually take several years and include a large population of patients, so there can be a considerable cost and time investment to the pharmaceutical company, which is why these medications can be quite pricey when they are new," Samolitis explains.
By contrast, OTC products have fewer hoops to jump through. "OTC ingredients are cleared by the FDA as long as they contain certain standards of 'acceptable' ingredients, dosages, instructions for use, and labeling," Samolitis says. Where it gets iffy is that the "studies" done for these products are often "small and subjective and the results can be 'faked' to make the product results seem more dramatic," Samolitis says.
Are Prescription Ingredients Better?
The ingredients in prescription products are often stronger than the over- the-counter stuff. Plus, if you're using a prescription product, that means a trained medical professional has diagnosed your problem and recommended the proper treatment. So you have a pretty good chance of seeing results.
"We know what to expect when prescribing a certain medicationâ€”the ingredients are tested and true, and there are clinical studies done on real people to demonstrate the effect," says Jessie Cheung, MD, dermatologist, and director of Cheung Aesthetic & Wellness. "With OTC products, we have no idea if the ingredients actually work on real people. The manufacturers can't make a claim on any efficacy beyond changing the 'appearance' of the skin, which any moisturizer can do by simply adding hydration."
That doesn't mean you should disregard OTC products altogether. "There are many OTC active ingredients that have excellent efficacy and may be very similar to prescription products, but usually in a lower potency," Samolitis says.
What's more is that over time, "some drugs that have been proven to be safe and effective will go from prescription-only to over-the-counter," adds dermatologist Dendy Engelman, MD.
Are Prescription Products More Effective?
"Yes and no," Engelman says. It's true that higher dosages of ingredients (in this case, prescription products) can take effect quicker. And there are certain ingredients that dermatologists agree are much more effective in higher doses. These include tretinoin (or Retin-A) and hydroquinone.
But just because a product is stronger doesn't mean it's right for your condition. "Thus, as a physician, for OTC cosmeceuticals, I try them on myself, my staff, and then interested patients and look to see if they seem to work based on physical exam and user feedback," says dermatologist Cynthia Bailey, MD.
Sometimes the OTC stuff works just as well (or better). This is especially common in the case of benzoyl peroxide, an OTC ingredient that is often more effective for acne than prescription antibiotics, which acne-causing bacteria are resistant to. (Try Clinique Acne Solutions Clinical Clearing Gel, $18, or Clean and Clear Continuous Control Acne Cleanser, $7).
Dermatologists also agree that OTC chemical exfoliants are very effective for brightening skin, fighting fine lines, and preventing breakouts. We recommend RenÃ©e Rouleau Ultra Gentle Smoothing Serum ($49) and Pixi Glow Tonic ($15).
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