Skincare or Prescription? Why the Best Results Often Come From Both

By Dr Naomi Mackle, Dermatology Specialist, Medical Director of Adare Dermatology Clinics and Founder of REFORM Skincare

Patients today are better informed about their skin than ever. Instagram, TikTok, skincare bloggers and AI tools all offer advice, and some of it is genuinely good. But some of it is not, and much of it is generic. At Adare Dermatology Clinics, one of the most common things we see is a patient who has tried skincare alone, or a prescription cream alone, and is frustrated that neither has worked. Very often, the answer is the right combination of the two.

Start with skincare

Many simple, common skin problems, such as mild acne, mild rosacea and the dark marks acne leaves behind, can improve a great deal with a well-designed skincare routine. The right cleanser, active ingredients, moisturiser and sunscreen, used consistently, make a real difference.

Free personalised routines: if you would like skincare advice alone, the REFORM Skincare website has a free tool where you describe your skin concerns and receive a tailored skincare routine. It is a simple, no-cost starting point.

When skincare alone is not enough

Skincare has limits. If your acne keeps coming back, your redness is persistent or your pigmentation is not fading, you may need a prescription treatment. But we also find that a prescription cream on its own often disappoints, particularly if it is used with the wrong cleanser, without a moisturiser, or without sun protection. Prescription treatments can be drying and irritating, and an unsupported skin barrier makes them harder to tolerate, so people stop using them.

Combining the right prescription treatment with the right skincare routine tackles the problem from both sides: the prescription treats the underlying condition, and the skincare keeps the skin clear, comfortable and protected so the treatment can do its job.

How a photo or virtual consultation fits in

This is exactly where our photo and virtual consultations help. A dermatology expert can look at your skin, recommend a prescription treatment where it is needed, and build the right skincare routine around it, so that the two work together rather than against each other. For simple, clear-cut problems, a photo consultation with a prescription cream is often enough. For more severe or persistent problems, a virtual consultation allows a fuller assessment and, where appropriate, stronger treatment with ongoing reviews.

An example: acne

For acne, a good routine targets the main causes: oil, blocked pores, inflammation and the marks left behind. Our REFORM Anti-Blemish Kit is designed around these:

• Salicylic acid foaming cleanser: removes excess oil and helps clear blocked pores. Salicylic acid is nearly always needed for very oily skin.

• Anti-Blemish Cream: combines zinc, salicylic acid and a high percentage of niacinamide to reduce oil production, calm inflammation and help prevent the dark marks acne leaves behind.

• Repair and Renew Gel: a glycolic and mandelic acid gel that gently removes the surface skin cells that block pores. 

Tailored to your skin: not everyone with acne has the same skin. If you have sensitive skin, eczema or allergies, salicylic acid can sometimes cause a reaction, so we may switch the cleanser to our gentler glycolic acid foaming cleanser. We also often recommend the glycolic cleanser if your main concern is the dark marks acne leaves behind and your skin is not particularly oily, as glycolic acid is very good at fading stubborn post-acne pigmentation.

We pair the kit with the REFORM Everyday Moisturiser, which supports the skin barrier without clogging pores, and an oil-free sunscreen. Where a prescription treatment is also needed, a dermatology expert will advise how to combine it with your routine safely, and whether to adjust or pause any products.

Why oil control and barrier repair go together

Oil is normal. It travels up through the pores to lubricate the skin and hair, and it helps skin look healthy. In the teenage years, and for some people well beyond, the skin simply makes too much. That excess oil blocks the pores, which leads to inflammation and lets acne bacteria (Cutibacterium acnes) multiply. If you do not control the oil, you will not get rid of acne. That is what a good skincare routine is for.

But stripping the skin is not the answer. If you over-cleanse or use harsh products without a moisturiser, the skin barrier is damaged, the skin becomes sensitised and red, and it often responds by producing even more oil. So oily, acne-prone skin still needs a moisturiser and a sunscreen every day. Both simply need to be oil-free or non-comedogenic, meaning they will not block pores.

Even with a good routine, the occasional spot is normal, for example around the menstrual cycle, or after sweating and exercise, which we see a lot in teenage boys who play plenty of sport. That is where a prescription treatment applied to the skin comes in. The two work together: the routine controls the oil and protects the barrier, and the prescription treats the spots that still appear.

Why sunscreen matters even more during treatment

Sunscreen is essential for anyone with acne, rosacea or pigmentation. Sun exposure deepens acne marks and post-inflammatory redness and pigmentation, and makes them last longer. It also matters for another reason: many medicines used for skin conditions make the skin more sensitive to the sun or more prone to pigmentation. These include some acne tablets, some hormonal treatments and prescription retinoid creams. Using them without daily sun protection can lead to burning, irritation and worse marking.

The right sunscreen for acne-prone skin must be oil-free and must not block pores. REFORM's Mineral SPF 30 and SPF Mist are both oil-free, and the mist leaves no white cast, which makes it easy to reapply and popular with all skin tones.

Why expert advice still matters

Information online can be a useful starting point, but it cannot examine your skin, take your history, recognise when something needs a closer look, or tell you how a prescription treatment will interact with the products you use. Our dermatology experts have extensive experience in acne, rosacea, pigmentation and scarring, and can give you balanced, personalised advice, including when skincare alone is enough and when it is not.

Summary

Skincare alone can improve many mild skin problems, and our free REFORM tool is a good place to start. When it is not enough, a prescription treatment combined with the right skincare routine often gives far better results than either alone. Daily, pore-friendly sunscreen protects your results, especially during treatment. If you are not sure what you need, a photo or virtual consultation with one of our dermatology experts is a quick, easy way to find out.

REFORM Skincare was founded by Dr Naomi Mackle and is the in-house range of Adare Dermatology Clinics. Recommendations are always made on clinical need.

Need more than skincare? Book a photo or virtual consultation with Adare Dermatology Clinics, wherever you are in Ireland or the UK.

Related reading: Photo, Virtual or In-Person? Choosing the Right Dermatology Consultation; Azelaic Acid: Over-the-Counter vs Prescription.

This article is for general information and does not replace a consultation. Prescription treatments are only provided after an appropriate medical assessment.