In the old days a pharmacy was a facility where experts actually hand-mixed treatments for particular ailments. The practice is called compounding, and it used to be commonplace. These days, in dermatology, the practice continues, albeit not as much as it used to: we call it bespoke skincare Rx. Most people don’t realize it can be even more cost-effective and personalized, treatment-wise, than classic mass-produced prescriptions. Lately, with the increasing costs of skincare prescriptions, compounding has been getting more popular, which is great for you—the patient.
Here’s a little bit more about how it works, why it works, and why you should ask your dermatologist about compounding.
WHAT IS COMPOUNDING — AKA BESPOKE RX?
Think of the prescriptions you take today or may have picked up in the past for a stomach bug or seasonal flu. It may be hard (or impossible!) to name a single one that you didn’t pick up from a CVS or Duane Reade, and there’s a good chance this medicine was either a generic or big-brand name that thousands of others have taken for that same ailment. Essentially, a one-size-fits-all solution.
Now think of a medication created just for you based on your personal needs (allergies/lifestyle preferences) and concerns. Let’s call it bespoke Rx. It may sound crazy, but this is in fact far more common practice than you think… this is the practice of pharmaceutical compounding.
If you were to ask your grandparents or great-grandparents about ‘custom medications’ that were tailor-made or even created right in front of them, it would not sound all that unfamiliar. In the 30s and 40s compounding was commonplace. Patients would visit their local pharmacy for every form of ailment and a pharmacist would physically make the tincture, pill or cream right there and then. A patient (your grandmother) could pick up their fountain drink and some groceries alongside their treatment for the common cold, the everyday rash or a prescription for anxiety or depression. Talk about service!
While compounding today does a look a little different than it did decades ago (no fountain drinks), the rise of commercialized medicine has not diminished the need for this essential service. We live in a world of prescriptions where patients can be treated as individuals with unique needs, and medications that are either on shortage or have become price restrictive can be made by certified and licensed professionals for a fraction of the cost.
PRESCRIPTION COSTS ARE RISING, DERMATOLOGISTS ARE COMPOUNDING MORE
It might seem counterintuitive, but the practice of compounding can actually be cheaper than buying prescriptions. Did you know that 68% of prescriptions go unfulfilled due to cost? It’s a scary and sad reality, especially for those who cannot live comfortably without their medication (nor should they have to). In the past, patients could fill a prescription for their psoriatic arthritis medication for the cost of a co-pay. Today that could be a cost of up to $1,500 out of pocket with commercial options!
This isn’t only a medical issue, but a cosmetic one. We remember the days when Tretintoin (think Retin-A micro and TriLuma) cost $30 for a 30-day supply. Fast-forward to today and these prescriptions can range from $120-$420. This is a huge bill to swallow (even by beauty standards).
What we do see is that dermatologists want to be able to provide patients the great care they need, at a price they’re able to afford. Compounding fills this important need-gap. In fact, compounding pharmacies can often compound a prescription for up to 60% less than its commercial equivalent!
HOW DOES COMPOUNDING MAKE YOUR SKINCARE Rx MORE EFFECTIVE?
The skincare that is most effective is the skincare that you’ll actually use. In that way, compounding can:
Affordability. Make prescriptions more affordable so you can justify integrating it into your skincare regimen without breaking the bank
Custumization. Adjust prescriptions so they’ll meet your lifestyle and cultural requirements (free of parabens and perfumes, kosher equivalents etc.)
Free Of Allergens. Eliminate allergens that could be causing adverse effects or sensitivities that may impact the positive effects of the Rx (dairy, soy and gluten are the most common) or by adding actives to a formula to make it an all-in-one problem solver.
Layering. Combine multiple medications into a single format rather than layering on multiple products to achieve the same result—because who wouldn’t want to save time?
WHAT ARE SOME EXAMPLES?
Spot treatment / skin lightening creams
Most commercial products use only one ingredient and contain excipients and fillers that can irritate the skin. Think: propylene glycol, DEA, TEA, etc. By compounding formulas these can be omitted from formulas therefore decreasing sensitivity and increasing efficacy (without inflammation, the active ingredients work better!).
Compounding pharmacies can go above and beyond a common bleaching agent and incorporate other active ingredients such as zinc to calm inflammation and clindamycin to control bacteria… so often hyperpigmentation is accompanied by one of its BFFS: acne! Why not tackle both issues with a single product? Everyone loves a multi-tasker.
Chicken skin AKA Keratosis Pilaris (KP)
If you have KP, we feel your pain. Traditional remedies to treat the condition have suggested a layering approach of 2-4 products with exfoliating and soothing actives. Compounding easily combines these into one (or sometimes two) products so that you can treat the stubborn skin bumps in fewer steps.
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