Putting Your Best Face Forward: Dermatology Compounding for Anti-Aging and Skin Disease
Although I always enjoyed clear skin, the downside to that is aging; dry skin like mine seems to age quickly! Between that and chronic eczema, I try to keep abreast of the latest in dermatological treatments. Modern dermatology compounding is on the rise, in large part due to an increase in demand for anti-aging products or “cosmeceuticals,” and the increased numbers of effective compounded prescriptions treatments for painful skin conditions. Last time we discussed some major advancements in dermatology compounding, and today we continue our examination of the latest developments in this area.
Various “cosmeceuticals” are now being prescribed for anti-aging purposes. This booming area is an important one for compounding pharmacy and dermatology specialists alike to become familiar with. Skin aging is generally understood to be caused by a combination of internal and external processes, including cell damage caused by cosmic irradiation, free radicals, and metabolic processes. For these reasons, custom compounding of both oral and topical antioxidants are commonly used by patients; some have added anti-inflammatory properties. These include alpha-lipoic acid, coenzyme Q10, dehydroepiandrosterone, glutathione, green tea, melatonin, selenium, and vitamins B3, C, E, and K.
Compounded topical medications containing palmitoyl pentapeptide provide skin with fine line reduction and anti-wrinkle benefit by stimulating collagen production. Topical medications containing adenosine have been shown to reduce “crow’s feet” and glabellar lines (the lines that appear between the eyebrows from frowning). Topical use of retinol is also linked to reduction of wrinkles of the lower eyelids and dark under-eye circles. Custom hormonal compounds for topical use with estradiol, estriol, and progesterone are also linked to decreased wrinkle depth, increased elasticity of the skin, improved firmness of the skin, increased skin moisture, and substantially decreased pore sizes. Finally, topical use of DMAE (2-dimethylaminoethanol, deanol) may boost the effects of other antioxidants, help prevent sagging skin, increase smoothness, make facial muscles appear leaner, and reduce fine lines.
Custom Compounding for Rosacea and Contact Dermatitis
Rosacea is a chronic, inflammatory skin disease usually seen on the face. The disorder produces small, red bumps which are actually pus-filled pustules. These lead to a general redness and swelling in the face. Rosacea is often mistaken for skin allergies, acne, contact dermatitis, or eczema, and so it often doesn’t receive the proper treatment and gets worse over time. Contact dermatitis is an itchy, red rash that can appear on the face and may cause inflammation, but it is caused by something acute, such as contact with cosmetics, jewelry, perfumes, soaps, and poisonous vegetation like poison ivy or poison oak. Both rosacea and contact dermatitis are inflammatory dermatoses, skin diseases that cause inflammation.
Custom compounding is very useful in the treatment of inflammatory dermatoses. This is because compounded topical medications can be made to suit the specific needs of the user, and may contain both anti-inflammatories and other medications. NADH, the reduced form of beta-nicotinamide adenine dinucleotide, is one such component that can be used for its antioxidative properties in ointments. Topical use of 1 percent NADH in compounded prescriptions can be extremely effective for treatment of contact dermatitis and rosacea. Niacinamide is a form of vitamin B3 made in the body. It is very useful in the treatment of rosacea as an assistive component with other active ingredients, including benzoyl peroxide, DMAE, metronidazole, and sodium hyaluronate.
Compounded Prescriptions for Eczema, Psoriasis, and Scalp Seborrheic Dermatitis
Eczema is a chronic kind of skin swelling or dermatitis that is painful, itchy, and unsightly. It may be influenced by allergies, heredity, skin irritations, and stress. Psoriasis is also a chronic problem, but it is an autoimmune disease of the skin that causes red, scaly patches or plaques, most frequently around the buttocks, ears, elbows, genitals, knees, navel, and scalp. Experts believe psoriasis has a genetic component and that excessive consumption of alcohol, mental stress, smoking, and withdrawal of systemic corticosteroid medications may worsen the condition. Both eczema and psoriasis can be stressful and embarrassing for patients, as they are unsightly in addition to the physical discomfort they produce. Scalp seborrheic dermatitis includes basic dandruff and cradle cap.
Compounding pharmacists can help patients with each of these issues. Topical pyrithione zinc-based compounds are effective in the treatment of scalp seborrheic dermatitis and dandruff, with no reduction in effectiveness even when used for extended periods of time. Topical clobetasol propionate has been proven effective in the treatment of psoriasis, and can be compounded for use in lotions, creams, shampoos, or sprays, as well as the more traditional ointment. Both psoriasis and eczema can be helped with topical prescriptions containing vitamin B12. Methotrexate, used in chemotherapy, is far more easily tolerated when applied topically; in this form it is effective against psoriasis. And compounds containing both salicylic acid and tacrolimus ointment are more effective in the treatment of plaque psoriasis than is salicylic acid alone.
The ways that custom compounding can work to assist the dermatologist and his or her patient are astounding. Dermatology compounding is a lucrative area, with more and more patients creating demand for products tailored to meet their specific needs.
For information about dermatology compounding and other topical medications, please contact Pharmaceutica North America. We are your resource for high-quality bulk compounding materials, and we can advise you about treatment regimens and effective carrying agents.