Acne, a very common problem especially in teenagers, has many possible treatments available, but for multiple reasons an alternative may be needed. Many treatments for acne involve the use of antibiotics, which may have additional side effects and the use of which may contribute to the emergence of resistant microbes. A compounded, non-antibiotic topical treatment could be a useful alternative.  In some cases common treatments simply do not work well enough.  Combinations of creams may prove to be more successful than current therapy. Topical nicotinamide compared with clindamycin gel in the treatment of inflammatory acne vulgaris. 

A 4% erythromycin and zinc combination (Zineryt) versus 2% erythromycin (Eryderm) in acne vulgaris: a randomized, double-blind comparative study.

Chemical Peels

Chemical peels have become a more popular way to treat many skin conditions.  While usually performed in a doctor’s office the preparation of the chemicals can be done at a compounding pharmacy. The use of chemical peelings in the treatment of different cutaneous hyperpigmentations.

Chronic Pruritus

Chronic itching is a common problem that can come from many different sources like dermatitis, psoriasis, or as a side effect of chronic opioid use. Treatment often includes corticosteroids or antihistamines, but these can be unsatisfactory in some patients who will then need a more individualized treatment. Options that can be compounded would include a topical naltrexone cream, topical immunomodulators, urea creams, topical anesthetics, and many more.

Treatment of pruritus with topically applied opiate receptor antagonist.

Diaper Rash and Incontinence

Rashes can commonly be found in both infants and adults with incontinence.  Compounded cholestyramine products have been shown to be a successful alternative to current market products. Cholestyramine ointment to treat buttocks rash and anal excoriation in an infant.

Cholestyramine ointment in the treatment of perianal skin irritation following ileoanal anastomosis.

Fungal Skin Infections

Fungus can cause many infections like athlete’s foot, ringworm, jock itch, and others. Many over the counter and prescription treatments are available, but as resistant strains are found a new treatment may need to be used. The combination of the usual antifungal and ibuprofen has been shown to be a successful alternative. Antifungal activity of ibuprofen alone and in combination with fluconazole against Candida species.