Compounded Topical Treatment with Retinoids: Effective Action for Acne and Photoaging

Compounded Topical Treatment with Retinoids: Effective Action for Acne and Photoaging

i-cadeceusSales of skin care products reached $2.25 billion in 2012, which is huge—but the more interesting statistic is that half of all skin care products are sold at pharmacies. These numbers don’t include prescriptions for topical products to treat acne and photoaging. Whether customers are purchasing OTC or prescription products, here’s the a significant takeaway: many individuals aren’t satisfied with the results. Either their current product isn’t effective or their treatment comes with unwanted side effects. Perhaps the greatest concern is that many patients taking prescriptions need topical alternatives, as oral retinoids can be associated with depression. Pharmacists have a distinct advantage for tapping into this market by reaching out to educate patients about tailored compounded topical treatment using retinoids.

Topical Retinoids for Acne and Photoaging

Ongoing concerns over antimicrobial resistance, combined with research showing retinoids deliver effective first-line treatment, have produced recommendations to move away from using oral antibiotics for most types of acne.1 Topical formulations that mix retinoids such as tretinoin, adapalene and tazarotene, with clindamycin and benzoyl peroxide offer the added advantage of suppressing clindamycin-induced resistance while limiting skin irritation from benzoyl peroxide.2

Topical retinoids fight signs of photoaging through their ability to regulate cell growth, boost collagen production and promote connective tissue remodeling. While tretinoin has been the gold standard, other retinoids can help reduce lines and wrinkles, improve skin texture and correct mottled pigmentation. Compounding pharmacists can offer their patients options as recent studies show that non-prescription retinoids also significantly improve fine lines and mottled pigmentation.3

Acne, Retinoids and Affective Disorders

Adolescents with frequent outbreaks of acne are two to three times more likely to have thoughts of suicide.4 Depression and anxiety frequently coexist with acne, but cause and effect are confounding and studies have produced conflicting results. Some researchers found that oral isotretinoin and topical retinoids improved mood as they treat acne. Others reported that taking oral isotretinoin was associated with depression.5

Where does such conflicting information leave compounding pharmacists? We can acknowledge the possibilities and be prepared to field all types of questions. Most importantly, never overlook a mental health problem especially when oral isotretinoin has been prescribed. Here are a few suggestions:

  • It’s hard to determine whether depression is related to acne or other teen- and life-related issues. Regardless of the cause, when depression or anxiety interfere with normal daily activities, it’s time to seek professional help. If a patient shares their concern, encourage them to seek out information and guidance from their physician.
  • Many individuals—especially teens—are unwilling to broach the topic of mental health, so it can be helpful to offer informational pamphlets about stress, depression, their association with acne and where to find help. Display the pamphlets in visible places near the OTC acne products.
  • As patients come in to drop off or pick up oral isotretinoin, take the time to talk with them about all potential side effects, including depression.
  • When you encounter patients, be prepared to take a holistic approach. Suggest products and supplements that help with stress, skin care and overall health.

Outreach Tips for Compounding Pharmacists

Topical retinoids represent a large market for your pharmacy, so don’t hesitate to reach out and become a local resource for people who are troubled by acne, worried about aging skin or who have questions about general skin care.

Connect and communicate with potential patients:

  • Ask staff to hand out pamphlets about compounded skin care and offer to talk with people buying any type of OTC skin care products.
  • Create a display of pamphlets covering diverse skin care concerns.
  • Plan a “healthy skin awareness” day. Set up a table of skin care products and partner with a local dermatologist to be on site to answer questions. Be sure to advertise.
  • Go out into the community. Offer to speak about skin care at health classes in local schools or health fairs.

Help patients get the most from topical treatment options:

  • Improve medication adherence by educating about the length of treatment, how long before they will see results, and the reality of side effects that make skin appear worse before it gets better.
  • Discuss the benefits of custom compounding, including the ability to combine customized meds with a base that’s suitable for their skin type and to reduce the risk of skin irritation by compounding lower doses.
  • Recommend cleansers and moisturizers to minimize skin irritation during treatment.

Standing as Local Experts Within the Community

Long before they visit a doctor for acne or aging skin, most people purchase over-the-counter products to treat their skin and improve their looks. For this group, compounding pharmacists are often overlooked as experts. It’s easy to counsel patients with prescription skin meds, but you can foster connections and boost your business by proactively reaching out to talk about skin care and the benefits of compounding topical treatments with retinoids.

Pharmaceutica North America meets your compounding needs with custom kits, bulk APIs and specialized base vehicles provides a selection of bulk APIs and specialized bases with great carrying capacity and emollient characteristics. Please contact us for more information about dermatology compounding and topical medications.

Show 5 footnotes

  1. “Journal of the European Academy of Dermatology and Venereology: Understanding Innate Immunity and Inflammation in Acne: Implications for Management,” June 2015,
  2. “Advances in Topical Acne Therapy: New Molecules, Vehicles and Delivery Mechanisms,” February 2015,
  3. “One-Year Topical Stabilized Retinol Treatment Improves Photodamaged Skin in a Double-Blind, Vehicle-Controlled Trial,” March 2015,
  4. “Suicidal Ideation, Mental Health Problems, and Social Impairment Are Increased in Adolescents with Acne: A Population-Based Study,” 2011,
  5. “Retinoic Acid and Affective Disorders: The Evidence for an Association.” January 2012,

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