If you’re an adult with moderate acne, or mild acne that hasn’t improved after two to three months of over-the-counter treatment, an online acne service is one way to get a prescription without booking an office visit. The five services still operating that we compare here (Agency, Curology, Hers, Musely and Nurx) differ most in what they prescribe, whether they offer pills, whether they take insurance, and how they bill.
In short: Curology, Hers, Musely and Agency mostly prescribe a single custom cream made by a compounding pharmacy. Nurx prescribes standard individual medicines, including pills, and bills private insurance for them. None of these services replaces an in-person dermatologist if you’re under 18, pregnant, or have deep cysts or scarring.
At a glance
| Service | What a clinician may prescribe | Oral options | Listed cost | Insurance | Provider age rule |
|---|---|---|---|---|---|
| Agency | Custom anti-aging cream (tretinoin-based) | None found on its pages | $80 every 2 months (about $40/month) | Cash-pay subscription. | 18+ only |
| Curology | Custom cream (e.g. tretinoin, clindamycin, azelaic acid); spironolactone | Spironolactone (up to 100 mg/day) | From $29.95/month, billed $59.90 every ~60 days | Cash-pay subscription. | 13–17 with parental consent; 18+ |
| Hers | Custom cream (e.g. tretinoin, clindamycin, azelaic acid) | Birth control pills (separate Hers service) | Not confirmed; reported ~$25–$29/month | Cash-pay subscription. | 13–17 with parental consent (topicals only); 18+ |
| Musely | Set-formula cream (e.g. tretinoin, clindamycin, niacinamide, azelaic acid) | None found on its pages | $30/month + $20 visit fee | Cash-pay. | 18+ (under 18 with parental consent) |
| Nurx | Individual Rx: tretinoin, topical/oral antibiotics, spironolactone, birth control | Antibiotics, spironolactone, birth control | $40 consult (1 year) + meds from $25/month | Bills most private insurance for medicines; does not accept Medicare, Medicaid or Tricare. | 18+ only |
How online acne treatment works
Most online acne services follow the same basic steps:
- You fill in a health questionnaire about your acne, what you’ve tried, medicines you take, allergies, and whether you’re pregnant or could become pregnant.
- You upload photos of the affected skin, usually face-on and from each side.
- A licensed clinician reviews them, usually without a live video call (this is called asynchronous or “store-and-forward” care). Depending on the service, that may be a physician, a nurse practitioner or a physician assistant.
- If treatment is appropriate, they prescribe it, and a partner pharmacy ships it to you, usually on a repeating subscription.
- You message the clinician with questions or side effects, and they can adjust the treatment over time.
Is this as good as seeing someone in person? For mild to moderate acne, there is reasonable evidence it can be. In a 2010 randomized trial of 151 people with mild to moderate facial acne, those whose follow-up visits happened online improved about as much as those who returned to the office, and satisfaction was similar in both groups. That trial studied follow-up with dermatologists, not today’s subscription companies, so treat it as evidence that the approach can work rather than an endorsement of any particular service.
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Who online acne care is not for
The services themselves screen people out, and you should too. See a dermatologist or your own doctor in person instead if any of these apply:
- You’re under 18. Some services accept teens with a parent’s consent, but we think teens are better served in person with a parent or guardian.
- You’re pregnant, breastfeeding or trying to conceive. Tretinoin, spironolactone and tetracycline antibiotics are among the acne medicines avoided in pregnancy, according to the American Academy of Dermatology.
- You have deep, painful nodules or cysts, severe acne, or scarring. These need treatments these services don’t offer.
- Your breakouts came with irregular periods, new hair growth or other new symptoms, which could point to a hormonal condition worth checking in person.
- You’re not sure it’s acne. Rosacea, fungal (Malassezia) folliculitis and perioral dermatitis can look similar but are treated differently.
Our guide to when you should see a dermatologist for acne goes through each of these in detail.
The services, one by one
We list the services alphabetically. The notes on who each might suit are our editorial judgment, based only on what each company publishes.
Agency
Agency is a sister brand of Curology, run by the same company, and its pages focus on aging skin: fine lines, texture and dark spots. Its “Future Formula” is a custom cream that can include tretinoin, which also treats acne. It may suit an adult whose main goal is anti-aging with occasional breakouts. If acne is your main problem, a service built around acne is likely a better fit.
- Who it's aimed at
- Adults whose main goals are fine lines, texture or dark spots, with occasional breakouts.
- Age rules
- Adults only. Curology, Inc. says it does not offer Agency to anyone under 18.
- Pregnancy
- Agency says not to use its tretinoin formulas if you're pregnant, breastfeeding or trying to get pregnant.
- What a clinician may prescribe
-
- A custom "Future Formula" cream with up to 4 actives, which may include tretinoin, azelaic acid, tranexamic acid and niacinamide
- Format
- One custom compounded cream (optional add-on formulas)
- Cost
- Agency lists Future Formula refills at $80 billed every two months (about $40 a month), shipping included, and has advertised 50% off the first month for new subscribers.
- Insurance
- Cash-pay subscription.
- Things to know
-
- Its product pages center on aging skin, not acne. If acne is your main problem, a service built around acne may fit better.
- Compounded formulas are not FDA-approved products (see "Custom formulas vs standard prescriptions").
Curology
Curology prescribes a custom cream that can combine tretinoin with up to two other actives, such as clindamycin (an antibiotic) or azelaic acid, and it offers oral spironolactone for some adult women with hormonal acne. Curology says it caps spironolactone at 100 mg a day and refers people who need a higher dose to in-person care, because higher doses need closer monitoring. It may suit adults with mild to moderate acne who want one product, and adult women whose breakouts follow their cycle.
- Who it's aimed at
- People with mild to moderate facial acne who want one custom cream, and some adult women with hormonal acne.
- Age rules
- Curology accepts patients 13 to 17 only with a parent or guardian's consent, and no one under 13. (AcneRid still recommends in-person care for anyone under 18.)
- Pregnancy
- Tell the provider if you are pregnant, breastfeeding or trying to conceive: tretinoin and spironolactone are not used in pregnancy.
- What a clinician may prescribe
-
- A custom cream that can combine tretinoin with up to two other actives, such as azelaic acid, clindamycin or tranexamic acid
- Oral spironolactone for some adult women with hormonal acne (Curology says it limits the dose to 100 mg a day and refers people who need more to in-person care)
- Format
- One custom compounded cream, plus optional cleanser and moisturizer; oral medicine where appropriate
- Cost
- Curology's help center lists a basic plan at $29.95 a month ($59.90 per shipment, each sized to last about 60 days, free shipping) and a premium plan at $34.95 a month ($69.90 per shipment). It has offered a free first month for new members who pay $5.45 shipping and handling.
- Insurance
- Cash-pay subscription.
- Things to know
-
- Care is asynchronous: you send photos and answers, and a dermatology provider replies by message.
- Compounded formulas are not FDA-approved products (see "Custom formulas vs standard prescriptions").
Hers
Hers is the women’s brand of Hims & Hers Health. After an online visit, a provider can prescribe a custom acne cream that may contain tretinoin, clindamycin, azelaic acid and niacinamide. Hers also prescribes birth control pills online, and some combined pills are FDA-approved to treat acne, but that is a separate service. It may suit adult women who want a custom cream and already use, or are considering, Hers for other care. Men would use its sister brand, Hims.
- Who it's aimed at
- Adult women who want a custom topical cream. Its sister brand, Hims, serves men.
- Age rules
- Hers' terms allow 13- to 17-year-olds, with a parent or guardian's consent, to use it for topical acne care only. (AcneRid still recommends in-person care for anyone under 18.)
- Pregnancy
- Tell the provider if you are pregnant, breastfeeding or trying to conceive: tretinoin is not used in pregnancy.
- What a clinician may prescribe
-
- A custom acne cream that may contain tretinoin, clindamycin, azelaic acid and niacinamide, as the prescriber decides
- Hers also prescribes birth control pills online; some combined pills are FDA-approved to treat acne
- Format
- One custom compounded cream
- Cost
- We couldn't confirm a list price for acne treatment on Hers' own pages; the price is shown during its online visit. Third-party reviews published in 2026 report about $25 to $29 a month, with introductory offers. Treat these figures as approximate. Price not found on the provider's own site; figure from third-party reviews.
- Insurance
- Cash-pay subscription.
- Things to know
-
- Hims & Hers closed its separate dermatology brand, Apostrophe, in 2025 (see below), so older reviews of Apostrophe don't apply.
- Compounded formulas are not FDA-approved products (see "Custom formulas vs standard prescriptions").
Musely
Musely offers a set range of prescription creams at a flat monthly price, plus a one-time doctor-visit fee for each new prescription. One of its published acne formulas combines low-strength tretinoin (0.015%) with clindamycin, niacinamide and azelaic acid, and the doctor can adjust the ingredients. It may suit adults who want a predictable price and a single product.
- Who it's aimed at
- Adults who want a pre-designed prescription acne cream at a fixed price.
- Age rules
- Musely's help center says patients should be 18 or older; anyone under 18 needs a parent or guardian's consent on the visit. (AcneRid still recommends in-person care for anyone under 18.)
- Pregnancy
- Musely says it generally does not recommend its treatments during pregnancy or while nursing, and that tretinoin should not be used then.
- What a clinician may prescribe
-
- The Acne Cream: one published formula lists tretinoin 0.015%, clindamycin 0.75%, niacinamide 4% and azelaic acid 2%; the doctor can add or leave out ingredients
- Format
- One compounded cream from a set range of formulas
- Cost
- Musely lists The Acne Cream at $30 a month. A $20 doctor-visit fee is charged for each new prescription; Musely says it covers the online visit, the prescription and 60 days of messaging with the doctor. Shipping is free.
- Insurance
- Cash-pay.
- Things to know
-
- Starting a different treatment later means a new visit fee.
- Compounded formulas are not FDA-approved products (see "Custom formulas vs standard prescriptions").
Nurx
Nurx works more like a traditional prescriber: instead of one custom cream, it prescribes individual medicines such as tretinoin, topical antibiotics, oral antibiotics, spironolactone and combined birth control pills, and it bills most private insurance for them. It says it can’t serve new patients under 18 or treat anyone who is pregnant. It may suit adults with moderate or hormonal acne who might need a pill, or who want to use insurance to lower the cost of medicines.
- Who it's aimed at
- Adults with moderate or hormonal acne who may need an oral medicine, or who want to use insurance.
- Age rules
- Nurx says it cannot serve new patients under 18.
- Pregnancy
- Nurx says it cannot treat people who are pregnant, because some of the medicines it prescribes are unsafe in pregnancy.
- What a clinician may prescribe
-
- Topical prescriptions such as tretinoin and topical antibiotics
- Oral options such as doxycycline or minocycline, spironolactone, or combined birth control pills
- Format
- Individual prescription medicines rather than one custom cream
- Cost
- Nurx charges a $40 consultation fee that covers a year of care and is not billed to insurance. Without insurance, it lists topical prescriptions from $25 a month and oral medicines from $15 to $30 a month. It also charges a $3 support fee in any month an order is processed.
- Insurance
- Bills most private insurance for medicines; does not accept Medicare, Medicaid or Tricare.
- Things to know
-
- Lists oral medicines and bills insurance for them, which may suit you if you need a pill or want to use your plan.
- Your copay, if you use insurance, depends on your plan.
What happened to Apostrophe?
Hims & Hers Health announced in March 2025 that it was shutting down Apostrophe, the online dermatology brand it bought in 2021, and folding dermatology care into its Hims and Hers brands. If you find older reviews or discount codes for Apostrophe, they no longer apply.
Custom formulas vs standard prescriptions
This is the biggest practical difference between these services, and it’s easy to miss.
Compounded custom creams (Agency, Curology, Hers, Musely) combine several ingredients in one product, made by a pharmacy for you. That’s convenient: one step, one subscription. But the FDA says compounded drugs are not FDA-approved, which means the agency does not review them for safety, effectiveness or quality before they reach patients. The individual ingredients, such as tretinoin and clindamycin, are well studied, but a particular combined cream hasn’t gone through the FDA approval process.
Standard prescriptions (Nurx) are FDA-approved products, often generics, that any pharmacy can fill. You may end up with two or three separate products instead of one, but they can often be billed to insurance, and you can keep using the same medicine if you later switch to your own doctor.
Either way, the approach dermatologists recommend is similar. The 2024 American Academy of Dermatology acne guidelines give strong recommendations to benzoyl peroxide, topical retinoids (like tretinoin), topical antibiotics and, for more stubborn acne, oral doxycycline, and they support combining treatments that work in different ways. Dermatology guidance has long advised against using an antibiotic on its own, because acne bacteria can become resistant. If you’re prescribed a topical or oral antibiotic, ask whether you should use benzoyl peroxide alongside it.
What these services don’t offer
- Isotretinoin. We did not find it offered by any of these five services on the pages we reviewed. It can only be prescribed through the FDA-required iPLEDGE program, with pregnancy testing and regular follow-up, and is usually managed by a dermatologist you see in person.
- Procedures. Steroid injections for painful cysts, drainage of large cysts, and scar treatments all need an in-person visit.
- A physical exam. Photos can miss things. If your skin isn’t improving as expected, an in-person visit can catch a condition that only looks like acne.
How to compare the real cost
Monthly prices look similar, but fees and billing differ. Here is a rough first-year cost using each provider’s lowest listed price, ignoring promotions, taxes and insurance. It is only an illustration: your actual cost depends on what you’re prescribed.
| Service | How we worked it out | About |
|---|---|---|
| Agency | 6 refills × $80 | $480 |
| Curology | 6 shipments × $59.90 (basic plan) | $359 |
| Hers | Price not confirmed on Hers’ own pages | — |
| Musely | $20 visit fee + 12 × $30 | $380 |
| Nurx (no insurance, one topical) | $40 consult + 12 × $25 + 12 × $3 support fee | $376 |
Before you sign up, it’s worth checking:
- How billing works. Curology and Agency bill about every two months, and subscriptions generally renew automatically. Find out how to pause or cancel before your first order.
- What happens if the first treatment doesn’t suit you. Ask whether changes to your prescription cost extra (Musely, for example, charges its visit fee again for a new treatment).
- Who prescribes. It may be a dermatologist, another physician, a nurse practitioner or a physician assistant.
- Whether the service operates in your state. Availability varies.
- What happens to your photos. Read the privacy policy, and share only what the service needs.
Alternatives worth considering
- Your own doctor or a dermatologist. If you have insurance, an in-person visit may cost less than a year of subscriptions, and a dermatologist can offer every option, including isotretinoin and procedures. The American Academy of Dermatology’s Find a Dermatologist directory lists board-certified dermatologists.
- A proper over-the-counter trial. If your acne is mild and you haven’t yet used adapalene 0.1% gel or benzoyl peroxide every day for about 12 weeks, try that first. Our comparison of Differin (adapalene) and tretinoin explains how the over-the-counter retinoid differs from the prescription one these services use. Our acne treatment path quiz includes a simple starter routine, and our benzoyl peroxide strength guide explains which concentration to pick.
How we put this comparison together
We compiled these facts from each provider’s own published pricing, eligibility and product pages on September 23, 2026, and link every source. Where we couldn’t confirm something on a provider’s own site, we say so. We did not sign up for or test these services, and we don’t publish ratings or scores.
AcneRid may earn a commission if you sign up through some links on this page. That never affects which services we include or what we say about them, and companies can’t pay to be listed. Read more about how we make money and how we research and review content. For a broader overview of online care, see our guide to how online acne treatment works.