Telehealth experienced an awakening during the darkest moments of the pandemic. From primary care providers to their dermatologists, people needed to find a way to seek professional care from home. Online skin-care prescription services, like Curology, Ro Derm and Apostrophe, have seen a surge alongside telehealth and it seems to continue even as the days of lockdown are in the rearview.

While experts say there’s no replacement for going to your dermatologist in person (we agree!), the millions of people that have found success with these services is worth noting. We talked with top dermatologists as well as some of the heads of the most prolific online prescription skin-care services to hear about the merits and potential misses of this kind of dermatological care.

The biggest and most undisputed plus about online dermatological prescription services is that they can help increase access to care. You can reach a doctor online regardless of where you’re located and “some provide reasonable cost for commonly used medications for common conditions like acne, rosacea and wrinkles,” says Rochester, NY dermatologist Lesley Loss, MD.

Palo Alto, CA dermatologist and associate medical director of Curology, Whitney Tolpinrud, MD, notes that one of the benefits of Curology is that people can access traditionally expensive skin care more affordably and quicker. “Technology has removed many barriers for management of various skin conditions. Furthermore, it can assist with education, access and lowering costs for many,” says Dr. Tolpinrud. Additionally, she notes that these services “have drastically reduced the time it takes to access a dermatology provider.”

“Patients want healthcare that’s convenient, accessible and affordable,” says Ro’s chief medical officer Melynda Barnes, MD. With these online services, patients “can talk to a provider about their skin concerns from the comfort of home and access treatment from diagnosis to delivery without having to wait weeks or months to access care,” she adds.

Dr. Barnes explains that something that sets Ro Derm apart from a dermatologist’s office is that they recommend a Custom Rx that has a powerhouse prescription, like tretinoin or azelaic acid, blended with other ingredients, like niacinamide, vitamin E or ceramides, to help abate side effects. “With Ro Derm, you aren’t getting a treatment any dermatologist could simply write a script for—you’re getting a prescription cream that’s custom formulated for you,” says Dr. Barnes.

Dr. Tolpinrud says Curology operates similarly. “Each member receives a free consultation with a licensed dermatology provider who selects your custom ingredients for your unique needs,” explains Dr. Tolpinrud. “Your dermatology provider is always by your side to make sure your formula is right for you—and can adapt it as your skin-care goals change.”

While there are certainly dermatologists on the other side of these sites, Dr. Loss points out that, while some do, not all websites note that they have board-certified dermatologists aboard. Additionally, Dr. Loss notes that many of these services offer private label products (which are not insurance-based and require personal payment) that are available by prescription through a dermatologist.

While Dr. Loss still recommends seeing an in-person dermatologist, she recognizes some of the merits of these online prescription services. On the other hand, Nanuet, NY dermatologist Heidi Waldorf, MD doesn’t recommend using the services. In her opinion, the goal of dermatologists is to care for the patient, which may include prescription medication from various companies, whereas the goal of online prescription companies is to sell their products.

Many of these companies recognize their limitations. “Of course, there are limits to the types of care that can be provided via telehealth,” says Dr. Barnes. “Ro Derm is by no means a replacement for a dermatologist, but it is leveraging technology and clinical expertise to build accessible, affordable, personalized skin care.”

Dr. Tolpinrud also notes the gaps in care these kinds of prescription services leave. “At this time, we cannot safely diagnose or manage certain skin conditions, including skin cancers. We also cannot perform procedures via telemedicine,” says Dr. Tolpinrud. “Procedures including injections, laser treatments, mole removals, and skin biopsies must be done by an in-person dermatology provider.”

The easy answer seems to be that the pandemic saw a renaissance of telehealth, which has since allowed online services to thrive. “They are popular because of quick access and 100 percent success in getting some prescription,” says Dr. Waldorf. Dr. Loss agrees that since the wait times to see dermatologists are often long, people are eager to start somewhere and turn to the most accessible option. “We have high standards for how conveniently and safely we can access our healthcare. People have gotten comfortable using telehealth and now are seeking it proactively,” says Dr. Barnes. 

Dr. Barnes also notes that after spending hours on Zoom meetings staring at themselves, people are more interested in caring for their skin. This trend has been well-documented as cosmetic procedures shot up over the past year. “At a time when everything that should feel normal doesn’t yet feel normal…it feels good to prioritize self-care. After all, self-care is healthcare,” says Dr. Barnes.

Conversely, Dr. Tolpinrud doesn’t see the rise in online dermatological prescription services as a trend, and feels these innovations are here to stay. “Now, as we’ve realized how affordable and convenient telehealth can be, people want to continue utilizing these tools in their daily lives.”

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