Why your dermatologist never recommends the skincare that Instagram bombards you with

Trending beauty ingredients and fun packaging is wasteful  when a prescription directs you towards medicated tubs and tubes. We dive into what works and why

In the wake of a slew of skincare labels being launched at lightning speed, why is it that your dermatologist rarely ever recommends an over-the-counter (OTC) skincare brand and instead wants you to buy local pharmacy products? Does a spot treatment by a cosmeceutical company not work as effectively as one by a pharmaceutical company? If yes, should we only use what the doctor prescribes? And finally, how is the entire skincare universe in India and abroad growing multifold, if none of them are good enough? Three dermatologists tell it like it is.

Pharmacy versus Over-The-Counter

“The primary distinction between pharmaceutical-grade and OTC skincare products lies in their potency, formulation, and purpose,” explains Dr. Kiran Sethi, a Delhi-based dermatologist and founder of Isya Aesthetics. “Pharmaceutical-grade products are designed with higher concentrations of active ingredients that are clinically proven to be effective. They undergo rigorous testing for purity, stability, and efficacy, ensuring that they meet the strict standards set by health authorities.”

Over-the-counter skincare—or the hundreds of brands you see crowding your social media feed—may be safe to use but lack in potency. “For OTC skincare, the concentration of active ingredients is lower and generic to avoid side-effects and safely be used by a larger population,” explains Dr. Madhuri Agarwal, a Mumbai-based dermatologist, founder and medical director, Yavana Aesthetics Clinic. “A pharmaceutical-grade skincare formulation has ingredients which are more chemically potent and more effective, and hence need to be supervised by a dermatologist and not be self-prescribed. They are also backed by extensive research and studies,” she adds. Simply put, while a cosmeceutical product may not necessarily be bad for your skin, it may not offer lasting or significant results. 

The case of regulation

Think of a pharmaceutical-grade skincare product being regulated exactly like medicines are—they have to be potent yet safe and deliver on results. “Medical-grade products undergo extensive testing and studies to establish efficacy and safety,” says Dr. Jaishree Sharad, a Mumbai-based celebrity dermatologist and founder, Skinfinitii. “These products have to undergo various stages of trials to prove their potency and a regulatory body finally reviews how safe they are to use. OTC products are not formulated under such stringent conditions. Although there are laws in place to check false claims as many products manage to fly under the radar due to [loopholes].” For instance, a Vitamin C serum from an OTC brand may get away with claiming ‘brightening’ as a benefit since the ingredient is clinically proven to brighten skin. However, it may not contain enough or the right kind of Vitamin C to actually deliver on the promise. Pharmaceutical-grade and clinical products cannot make such claims without proof since they have to receive the stamp of approval from governing bodies like the Food and Drug Administration (FDA) that require clinical trial results, studies, and proof. 

Do dermatologists trust OTC products at all?

Just as we consult a physician when our health is not functioning at its best, we see a dermatologist when our skin isn’t at its optimum either, with specific concerns. “If a patient comes in with acne, then a dermatologist will prescribe a pharmaceutical-grade spot treatment. You need something potent to alleviate the acne. Along with this, the dermatologist might prescribe an OTC face wash that the patient can use for the rest of their lives, since they have oily skin,” says Sethi. Both Sharad and Agarwal trust Indian pharmacy products because they have been developed keeping our skin type and weather conditions in mind. “The raw materials, concentration of the ingredient, pH value, all work in favour of providing maximum efficacy,” says Sharad. “Pharma-grade products are more concentrated and deliver faster results which is extremely rewarding for both doctors and patients. For example, a prescription strength tretinoin is superior for acne as well as anti-ageing as compared to its OTC counterpart retinol,” she adds. 

And no, dermatologists are not completely against cosmeceutical products. “If a dermatologist has had a good experience with an OTC product, there is no reason they won’t prescribe it,” confirms Sethi. “However, due to strict testing, dermatologists know that pharmacy products will have higher efficacy, reliability, and safety. These products are formulated to provide more consistent results. The known side-effects and interactions of pharmaceutical-grade products are well-documented, allowing dermatologists to prescribe them with confidence,” she further explains. 

Getting away with tall claims minus proven results? 

The harsh truth is that marketing often clouds consumer judgement—which is why Instagram may not be the best place to get your skincare advice from. “As is the case with many consumables, attaching a high-end brand name with any product heightens the public perception of the product quality,” explains Sharad. A higher price point, a brand name or celebrity endorsement do not guarantee efficacy.

“Often, luxury brands claim to be all-organic or add a token exotic ingredient to make their products look more marketable. However, sometimes, these luxury brands do have good products too whereby a lot of research goes into the making of the product,” adds Sharad. This is why due diligence on an individual level is extremely important when skincare is concerned. Impulsive shopping driven by  sales or attractive packaging or textures can cause more harm to your skin than good. 

If you have relatively problem-free skin—no chronic skin conditions, active acne, sensitivity or hyper-pigmentation—you can use cosmeceutical brand products. “It is generally considered okay to use certain OTC products like non-fragranced moisturisers, face washes, shampoos, and conditioners,” says Sharad. “While buying any OTC products, always be sure to check the ingredients list and make sure that they are meant for your skin type.” If you have dry, parched skin, that exciting-looking peel-off mask isn’t meant for you. 

French pharmacy versus Indian pharmacy brands

While the Korean skincare industry may currently have the best reputation globally, when pharmaceutical brands are in question, it’s the French that have got it down pat, something Indian companies will hopefully be able to achieve as well. French pharmacy brands such as Bioderma, Avène, La Roche-Posay, Embryolisse, and Caudalie have achieved cult status globally—you know they’re onto something when dermatologists are prescribing them as well. “Traditionally, the focus of Indian pharmacy products has been on ‘curing’ rather than ‘beautifying’,” says Sharad. “Most of the research and development is diverted towards ingredients that would help improve quality of life in individuals who are actually suffering from certain ailments. Skincare has become a booming industry globally and Indians have now become more and more aware of trending skincare ingredients.”

According to Sethi, “French pharmacy skincare brands have earned a global reputation for their effectiveness, supported by decades of strong research, development, and effective marketing. In contrast, while Indian pharmaceutical companies produce effective products, they may not have the same level of global recognition or marketing prowess.”

Money matters

Patients often attempt to treat their skin with products they discover online that promise high efficacy as visiting a dermatologist means an extensive prescription. However, this may do more damage to a person’s skin, prompting a visit to the doctor, and an even longer treatment plan than needed. The key to making the most out of your skincare investment is to use the right products consistently, especially if you have problematic skin, to heal your concerns, and then potentially switch to less potent formulas (which may be more reasonably priced) for maintenance. “Products such as serums or targeted treatments can be costly. But if you focus on the long-term value of effective treatments, you realise this is most likely only a one-time cost,” says Sethi. “While pharmaceutical-grade products may be more expensive initially, their higher efficacy can result in better outcomes, potentially reducing the need for additional treatments.”

Agarwal explains how Indian pharmacy brands can also be more economical. “When pharmaceutical products are manufactured in India, the cost of raw material and manufacturing is also often economical as the import taxes and costs are omitted, making it cheaper as opposed to brands that are imported into the country.” While dermatologists have formally been trained to only prescribe pharma brands, she acknowledges that with multiple OTC brand options today, it’s important to balance the two. “Dermatologists can balance their pharmaceutical skincare prescriptions which are absolutely essential for efficacy, with OTC brands that can support the prescription. At the same time, consumers need to be aware that while the OTC brands may be cheaper, they cannot always replace a pharmacy skincare for efficacy. Consumers should also balance their OTC purchases with consulting a dermatologist and using pharmacy skincare, especially when their skin issues persist despite experimentation with OTC skincare.”

The only product that is non-negotiable for Sharad is sunscreen. “Price doesn’t always equate with quality. Good skin is built with a consistent skincare routine, not with a hundred different expensive products. That being said, the only product one must not try to skimp on is sunscreen. Always buy a good quality sunscreen that’s made for your skin type,” she advises.

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