This review is written with the intent to be as unbiased as possible. However, it represents the opinion of an individual reviewer and is therefore subjective. Furthermore, at Nebula Genomics we seek to educate the public about the benefits of Whole Genome Sequencing. Information about our Whole Genome Sequencing DNA test is therefore incorporated into the review.
September 22, 2020
Table of contents
- 7 Facts from our Curology Review
- Curology Introduction
- A Primer on Skin and Acne
- Review of Curology
- Review of Curology Cost and Subscription Plans
- Review of Curology Privacy
- Other Curology Reviews
- Curology Pros and Cons
- The Genetic Basis of Acne
- Nebula Genomics
7 Facts from our Curology Review
- Curology location: San Diego, CA
- Products: Custom prescription skincare “superbottle”
- How it works: A dermatologist reviews the patient’s information and provides a custom acne treatment formula
- Privacy: sharing of aggregate customer data with third parties
- 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)
- Reviews: good – very good
- Complementary products: Nebula Genomics (DNA test that decodes 100% of DNA and provides reports on skin conditions)
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 in person visit with a physician. To date, the company serves patients in over 35 states.
Some products while using Curology include things like the dark spot formula (for spot patches) and acne body wash (for acne on any part of the body).
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.
Did you know you can test inflammation markers at home? Learn more in our article about at home inflammation tests.
Review of Curology
Review of the free 30-day trial ($4.95)
No need to make an appointment with a dermatologist in-person. Curology provides access to dermatological care from the comfort of your phone. Customers use their Curology login to upload photos of their face and neck. They also 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.
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 Curology 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.
- Hyaluronic acid: Helps skin retain moisture over time.
- Metronidazole: An antibiotic that can fight rosacea.
- Niacinamide: Vitamin B3 antioxidant that protects the skin against environmental damage and reduces inflammation.
- Salicylic acid: Dislodges dead skin cells that accumulate in pores.
- 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.
You should speak with professional about other products you are using before trying Curology. Some common skincare ingredients, such as benzoyl peroxide and retinol are not advised to be taken with Curology products.
Most customers begin with a 30-day Curology 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 Curology 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.
Review of Curology Cost and Subscription Plans
After a 30-day trial period, patients can continue to receive superbottles on a monthly or bimonthly basis.
How much is Curology?
- Small bottle (14 mL) of superbottle: $19.95 + $4.95 shipping and handling (every 30 days)
- Large bottle (27 mL) of superbottle: $39.90 with free shipping and handling (every 60 days)
- Large bottle (27mL) of superbottle with cleanser and moisturizer: $59.90 with free shipping and handling (every 60 days)
How to cancel Curology: To cancel, customers can click the “I want to cancel” button at the bottom of the payment page. This starts the cancellation process.
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.
Other Curology Reviews
Does Curology work? Customer reviews are mixed. Some patients saw results while others did not.
- Curology reviews on its website, including Curology before and after photos (4.7/5)
- Curology reviews on Trustpilot (3.1/5)
- Curology reviews on Facebook (4.2/5)
- Business Insider: I tried out 7 startups that aim to make it easier and cheaper to go to the doctor. An online dermatology visit turned out to be the best one.
Curology Pros and Cons
|Simplified routine||Requires a subscription|
|Order from the comfort of your home||Active ingredients are common and can be purchased individually, cheaper that the Curology 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.
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! This genetic test reads 100% of your DNA. That is 10,000 times more data compared to tests like 23andMe or AncestryDNA!
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.
And you might be interested in these companies that support aging well:
- Capillus (laser filled caps to stimulate hair follicles)
- Elysium Health (supplements designed to slow down aging)
- Keeps (prescription strength hair loss treatment)
- Neuriva (supplement to improve brain function)
- Nugenix (testosterone booster)
- Nutrafol (supplements for hair growth and thickening)
- Prevagen (a supplement designed to improve memory)
- Relief Factor (supplement to reduce pain)
- SeroVital (reduces signs of aging)
- TeloYears (uses telomere length to assess biological age)
- Test Boost Max (testosterone booster)
- Tru Niagen (supplements designed to slow down aging)
- Vegamour (plant-based hair care products)
- Viviscal (supplements for hair growth and thickening)
- Xtend Life (supplements, skincare, and superfoods for anti-aging)
- Zion Health (clay based skin products)
Plus, Pathway Genomics offers a clinic grade DNA test specifically for skin information!
Did you like our Curology review? You can read more reviews on our blog and check out our complete guide to the best DNA test kit and other home tests.