curology-review

Curology review – A personalized acne treatment subscription?

Rating based on our Curology review

7 Facts from our Curology review

  1. Curology location: San Diego, CA
  2. Products: Custom prescription skincare “superbottle”
  3. Privacy: sharing of aggregate customer data with third parties
  4. Cost: small bottle on monthly basis ($19.95 + $4.95), large bottle on a bimonthly basis ($39.90 + free shipping and handling), large bottle with cleanser and moisturizer on a bimonthly basis ($59.90 + free shipping and handling)
  5. Reviews: good – very good
  6. Complementary products: Nebula Genomics (DNA test that decodes 100% of DNA and provides reports on skin conditions) 
  7. Alternatives: Hers ($34 per bottle of treatment), Proactiv ($19.95 per month), CleaRx (49.95 bimonthly), Plexaderm

Curology Introduction

This is a review of Curology, a direct-to-consumer prescription skincare startup that was founded by Dr. David Lortscher in 2014. Dr. Lortscher wants to debunk the idea that skincare is one-size-fits-all. Indeed, Curology creates customized treatments for patients suffering from acne who otherwise would not have easy access to dermatologists. These treatments are delivered to patients directly – no need to make an appointment with a physician in-person. To date, the company serves patients in over 35 states.

Are you looking for a DNA test that decodes 100% of your DNA and identifies predispositions to skin conditions like acne? At Nebula Genomics, we offer Whole Genome Sequencing for only $299! This is the most complete DNA test! Click here to learn more!

A primer on skin and acne

Before we review Curology, let’s summarize some facts about skin health and acne.

Why is skin health important?

The skin is the largest organ in your body. It serves as a protective barrier between you and everything else in the outside environment. The skin is primarily made up of cells known as keratinocytes. These cells are essential – they serve three primary functions. First, they prevent foreign substances from entering the body. Second, they are simultaneously minimizing loss of moisture and heat from the body. Finally, these cells are necessary to maintain the structural integrity of the skin texture by forming tight bonds with each other and other cells that make up the skin.

The skin is divided into three layers: the hypodermis, dermis, and epidermis. Keratinocytes are the most common cell type found within the epidermis, which is the outermost layer. The epidermis contains hair, hair follicles, and sebaceous glands. The sebaceous glands secrete sebum, which is an oily, waxy substance produced by fat cells. Sebum naturally moisturizes the skin, preventing it from becoming dry and irritated. However, excess sebum production can result in acne.

What is acne?

Acne vulgaris, more commonly known as acne, is an inflammatory disease of the skin in which hair follicles become clogged with sebum, dead skin cells, and bacteria. Acne is incredibly common – it affects 50 million individuals in the United States. There are a number of different types of acne that can appear on the face and body, including closed plugged follicles (whiteheads), open plugged follicles (blackheads), pimples (pustules), and so forth. Acne is difficult to treat because it can be a result of a number of different factors. Acne can be caused by factors that can be controlled, including environmental factors (e.g. hormonal changes, diet, stress) and factors that cannot be controlled, such as genetic predisposition to acne.

Review of Curology

Review of the free 30-day trial ($4.95)

Overview of how Curology works.
Overview of how Curology works.

No need to make an appointment with a dermatologist in-person. Curology provides access to dermatological care from the comfort of your phone. Customers upload photos of their face and neck and fill out a questionnaire highlighting how frequently you get acne, past acne treatments that have been used, current medications one is taking, and skincare concerns goals.

Curology questionnaire.
Curology questionnaire.

The photos and questionnaires are sent to a board-certified dermatologist (e.g. dermatologist or dermatology physician’s assistant) through the brand’s website. This provider will evaluate the customer’s skin profile, skin type, and health history and subsequently build a custom treatment plan. The treatment includes a custom formula, otherwise known as a “superbottle,” which is a compounded prescription cream that contains three clinically proven active ingredients that can help eliminate acne and also provide additional brightening and anti-aging benefits (e.g. help reduce clogged pores, dark spots and fine lines). The active ingredients can include:

  • Azelaic acid: Skin exfoliator (i.e. sloughs off dead skin). It also interferes with the enzyme that catalyzes melanin (tyrosinase), effectively reducing hyperpigmentation.
  • Clindamycin: An antibiotic that can fight acne-causing bacteria. 
  • Metronidazole: An antibiotic that can fight rosacea.
  • Niacinamide: Vitamin B3 antioxidant that protects the skin against environmental damage and reduces inflammation.
  • Tranexamic acid: A synthetic derivative of the amino acid lysine. Combats hyperpigmentation.
  • Tretinoin: Boosts cell turnover.
  • Zinc pyrithione: An antibacterial and antifungal that restores skin balance and prevents unwanted bacteria from growing on your skin.

Many of these ingredients have both anti-acne and anti-aging effects.

Customization of treatments.
Customization of treatments.

Most customers begin with a 30-day free trial, in which individuals receive a month’s supply of a custom superbottle for free, only having to pay $4.95 for shipping and handling. Shipments are sent out within 1 to 3 days. In addition to a custom superbottle, customers also receive two additional items — a pH balanced cleanser and moisturizer. Moreover, customers have access to the aforementioned provider who is available to answer questions and offer suggestions, such as different over-the-counter cleansers and moisturizers, diet recommendations, and so forth. Insurance does not cover Curology.

Customer testimonials from 2016.
Customer testimonials from 2016.

Review of Curology subscription plans

After a 30-day trial period, patients can continue to receive superbottles on a monthly or bimonthly basis.

  • Small bottle (14 mL) of superbottle: $19.95 + $4.95 shipping and handling (monthly)
  • Large bottle (27 mL) of superbottle: $39.90 with free shipping and handling (bimonthly)
  • Large bottle (27mL) of superbottle with cleanser and moisturizer: $59.90 with free shipping and handling (bimonthly)

Review of Curology Privacy

While privacy is important to Curology, it is not necessarily the primary focus of the company. The company collects and stores a variety of personal and health information from customers. Personal information includes name, date of birth, sex or gender, address, order history, and so forth. Health information includes medical history, medications, allergies, photos for the purpose of diagnosis, and so forth. These data are primarily used to provide online dermatology services such that these data are shared with licensed providers. However, Curology may also share non-personal, de-identified, aggregated customer data with third-party service providers.  Ultimately, the company retains customer information, in particular medical records, for five years.

For more information, one can read Curology’s privacy policy here.

Other Curology Reviews

Curology Pros and Cons

ProsCons
Simplified routineRequires a subscription
Order from the comfort of your homeActive ingredients are common and can be purchased individually at a cheaper price.
Virtual access to healthcare providers (nurse practitioners)Not covered by health insurance

The genetic basis of acne

Beyond consulting with dermatologists and building effective skin care routines, there are certain aspects of acne that you cannot control, like your genetics. Let’s finish our Curology review with a look at the genetics of acne.

Acne twin studies

Acne is strongly genetic. If you have a parent or sibling with acne, you are four times more likely to also develop acne

In fact, based on a study of ~1,500 identical and fraternal twins, it is estimated that the heritability of acne is 81%. Other studies on acne have investigated if there is a link between genetics and sebum production, which is one of the factors involved in the appearance of acne. One study in a small sample of 20 pairs of identical and fraternal twins determined that sebum production is controlled by genetics, but the resulting severity of acne is variable and likely driven by some combination of genetic and environmental factors. 

Overall, this highlights the difficulty and complexity in understanding the etiology of acne.

Acne genome-wide association studies

More systematic evidence of the genetic basis of acne has been elucidated through genome-wide association studies (GWASs). 

By examining the genomes of ~7,000 individuals in the United Kingdom, a group of researchers identified three genomic loci associated with the condition. The identified loci also provided insight into the putative biological mechanisms that underlie the genetic basis of acne. For example, these loci are linked to the OVOL1, FST, and TGFβ2 genes, all of which are involved in the transforming growth factor beta (TGFβ) signaling pathway. The TGFβ pathway is implicated in a number of different processes, including cell growth, programmed cell death, otherwise known as apoptosis.

A more recent study that examined the genomes of ~27,000 individuals identified a total of 15 loci associated with acne, 12 of which are novel. Some of the novel loci are linked to the WNT10A and SEMA4B genes. Overall, these loci only explain 22% of the heritability of acne, highlighting the fact that further studies will need to be conducted. 

Once we have a more comprehensive understanding of the genetic basis of acne, we can develop more effective treatment options for patients.

Nebula Genomics

At Nebula Genomics, our goal is to empower you to discover more about your genome including your genetic predisposition to skin conditions like acne. This can help you determine the best skincare for you before purchasing products like Curology.

If you have already participated in 23andMe or AncestryDNA, you can upload your DNA data for free and get an expanded DNA report. We use a process called imputation to fill in the blanks left by typical DNA tests. As a customer, you have access to hundreds of traits and curated research studies through the Nebula Research Library, allowing you to stay up-to-date with the most cutting-edge research as it comes out, including research on skin health, and what it means about you and your DNA.

Furthermore, we offer the most affordable 30x Whole-Genome Sequencing service for $299! This genetic test reads 100% of your DNA. That is 10,000 times more data compared to tests like 23andMe or AncestryDNA!

Summary

Let’s summarize our Curology review. 

Curology is one of many telemedicine subscription-based companies focusing on treating acne. Its primary advantage is that it may be the most personalized acne treatment option that exists, especially as compared to alternatives such as Proactiv and Hers. This is because consultation with a licensed provider is included in the fee. 

Ultimately, Curology is an affordable and accessible alternative to expensive, in-person dermatology visits, which can cost up to $1,000 per year. 

Did you like our Curology review? Take a look at our reviews of BlueChew, Plexaderm, and Everlywell!

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