Skin Care: FSA and HSA Eligibility
Most cosmetic skincare isn't reimbursable from your FSA, HSA or HRA. OTC acne treatments, sunscreen and prescription skincare for diagnosed conditions can qualify.
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Short answer
Most skincare products sold for appearance are not reimbursable. But some skincare is. Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease and for the purpose of affecting any part or function of the body. OTC acne treatments and sunscreen SPF 15+ are reimbursable outright. Prescription skincare prescribed by a dermatologist for a diagnosed skin condition is often reimbursable with a letter of medical necessity.
You can pay with any card. FSA and HSA cards, credit cards, debit cards and cash all work. If your skincare needs a letter, request it before you buy. The letter has to be dated on or before the purchase it covers.
The answer: some skincare is reimbursable, most is not
Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease. Skincare products bought to improve appearance are personal expenses. But skincare prescribed for a medical condition or certain OTC remedies can be qualified medical expenses.
How to buy skincare
Pay with any card. Your FSA, HSA or HRA card, a credit card, debit card or cash all work. You don't need to buy from a pharmacy or a specific store. The administrator reimburses you from your account by check or deposit after.
If your skincare needs a letter, request it before you buy. The letter has to be dated on or before the purchase it covers, so request it now if you're planning to buy.
What's reimbursable outright, what needs a letter, what's not
Skincare falls into three categories under FSA, HSA and HRA rules. Some items are reimbursable without any letter. Some require a letter from a clinician naming a diagnosed skin condition. Most cosmetic skincare is never reimbursable.
Skincare product or type | Reimbursable? | Notes |
|---|---|---|
OTC acne treatments (benzoyl peroxide, salicylic acid creams or gels) | Reimbursable outright | Except for insulin, you can't include in medical expenses amounts you pay for a drug that isn't prescribed is the general rule, but CARES Act 2020 restored OTC drugs and medicines without a prescription to reimbursable status. |
Prescription acne treatments or creams from a dermatologist | Reimbursable outright | Prescriptions for treating skin disease are medical expenses. |
Sunscreen SPF 15 or higher, broad spectrum | Reimbursable outright | Sunscreen that blocks UV rays to prevent skin damage is a qualified medical expense. Cosmetic sunscreen-free skincare is not. |
Prescription skincare for eczema, psoriasis, dermatitis or other skin disease | Reimbursable outright | Medications and treatments prescribed by a dermatologist for a diagnosed skin condition are qualified medical expenses. |
Non-prescription creams or ointments for a diagnosed skin condition | With a letter | A clinician must write that you have a diagnosed skin condition and explain how the product treats it. Examples: moisturizer for severe eczema, anti-fungal cream for athlete's foot. |
Cosmetic skincare (anti-aging creams, serums for glow, brightening products, fillers, Botox) | Not reimbursable | Generally, you can't include in medical expenses the amount you pay for cosmetic surgery. Cosmetic skincare for appearance is excluded. |
General cleansers, soaps, shampoos, conditioners | Not reimbursable | General hygiene and toiletries are personal expenses even if medicated versions exist. A dermatologist-prescribed medicated shampoo for scalp psoriasis can be reimbursable with a letter. |
Face masks, peels or facials for appearance | Not reimbursable | Cosmetic treatments fall under the same rule as cosmetic surgery. A letter doesn't change that. |
When you need a letter
Most OTC and prescription skincare for a diagnosed condition needs no letter. Prescription acne treatments, dermatologist-prescribed creams for eczema or psoriasis, and OTC acne remedies are all reimbursable outright. Sunscreen SPF 15+ needs no letter.
You need a letter if you're buying a non-prescription skincare product or general item that a clinician recommends for a diagnosed skin condition. Example: your dermatologist recommends a specific non-prescription moisturizer for severe eczema. A letter explains that you have eczema and how the moisturizer treats it.
No letter exists for cosmetic skincare. Anti-aging serums, brightening creams, face masks for glow and similar products are never reimbursable, even if a dermatologist mentions them in conversation. The condition has to be a disease or diagnosed medical condition that the skincare treats, not appearance.
What the letter has to say
A letter for skincare must name a diagnosed skin condition. Eczema, psoriasis, dermatitis, severe acne, rosacea or fungal infection are examples. The letter must explain in one sentence how the specific skincare product treats it.
Example: Your dermatologist writes that you have diagnosed moderate eczema, and the specific product is recommended as part of your treatment regimen to manage flare-ups and prevent skin barrier damage. The letter must be dated on or before the purchase date.
Related items you can also use your account for
Your FSA, HSA or HRA covers much more than skincare. Prescription glasses and contact lens solutions are reimbursable outright. Sunglasses with a prescription are covered. Over-the-counter pain relievers, topical creams for muscle soreness and allergy medicines are all qualified expenses.
Dermatology services are reimbursable, including office visits with a dermatologist. The distinction is always the same: products or services that treat a diagnosed medical condition are covered. Products or services for appearance or general hygiene are not.
Getting skincare reimbursed with Burst
When the answer is 'with a letter', this is the letter. Request it from Burst in about two minutes, a licensed clinician reviews it, and it's typically in your inbox within 24 hours. $35 once. Burst then files the reimbursement claim with your FSA, HSA or HRA administrator, and the administrator pays you out of your account by deposit or check. If no letter is issued you pay nothing, and if the claim is denied you get the $35 back. One timing rule: the letter has to be dated on or before the purchase it covers, so request it first.
Get reimbursed for my skincare
Frequently asked questions
Is acne skincare reimbursable?
Yes. OTC acne treatments like benzoyl peroxide or salicylic acid are reimbursable outright. Prescription acne medications from a dermatologist are also reimbursable without a letter.
What about anti-aging creams or serums?
No. Anti-aging skincare and beauty products for appearance are cosmetic and not reimbursable. A letter doesn't change that.
Is sunscreen reimbursable?
Yes. Sunscreen with SPF 15 or higher that offers broad-spectrum coverage is reimbursable outright from your FSA, HSA or HRA. Cosmetic sunscreen-free skincare is not.
Is a dermatologist-prescribed moisturizer reimbursable?
If it's a prescription product, yes, it's reimbursable outright. If it's a non-prescription moisturizer recommended for a diagnosed skin condition like eczema, it's reimbursable with a letter.
Can I use my HSA for skincare for eczema or psoriasis?
Yes. Skincare prescribed for a diagnosed skin condition is often reimbursable. Prescription treatments are reimbursable outright. Non-prescription products need a letter explaining the condition and how the product treats it.
Is shampoo reimbursable?
Regular shampoo and conditioner are personal hygiene items and not reimbursable. A medicated shampoo prescribed by a dermatologist for scalp psoriasis or another skin condition can be reimbursable with a letter.
What about face masks or facials?
Face masks and facials bought for appearance are cosmetic and not reimbursable. A medicated mask prescribed for acne or dermatitis can be reimbursable with a letter from a clinician.
Do I need a letter for OTC acne cream?
No. OTC acne treatments like benzoyl peroxide or salicylic acid are reimbursable outright without a letter.
Keep reading: 75+ Surprising FSA/HSA Eligible Items (2025 Guide), What Can I Use My FSA Funds On?, HSA and FSA Eligible Items in 2026: Complete Guide, and all guides on this topic.
Sources
IRS Publication 502 - Medical and Dental Expenses (definition of medical expenses, OTC drug eligibility (CARES Act), cosmetic surgery and cosmetic procedures not reimbursable, general toiletries not reimbursable)
IRS Publication 969 - Health Savings Accounts and Other Tax-Favored Health Plans (FSA, HSA and HRA account rules and qualified medical expenses)
