Compounding for Acne
Custom dermatological compounds that are efficacious and economical.
Acne is the most common skin condition in the United States, affecting up to 50 million Americans annually. Compounding offers bespoke options to treat various types of acne.
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Common among adolescents and young adults, acne can last into adulthood. Acne is a non-contagious skin condition that can cause blackheads, whiteheads, pimples, and/or acne cysts or nodules (deep, painful breakouts).
Nearly 85% of teenagers experience acne, and, in total, over 50 million people have acne in the U.S. Acne can lead to permanent scarring, poor self-image, depression, and anxiety. 1
The understanding of acne pathogenesis is evolving. To date, the following associated factors have been identified:
The right treatment for each underlying condition:
Treat blackheads with adapalene to unclog pores.
Deep painful acne requires customized intervention to address clogged pores, bacteria, inflammation, and excess oil.
Guidance: Some patients must be encouraged to implement a gentle skincare routine. Attempting to scrub away blemishes or pop a pimple may further irritate the skin. Support patients by introducing a gentle skincare routine with alcohol-free products.
Oil-free skincare products, sunscreen, and makeup: Acne is exacerbated by clogged pores. Patients must be educated to choose “oil-free” and “non-comedogenic” products.
Patient management: Acne can have a significant impact on a patient’s self-image. While some treatment options do reduce swelling and redness quickly, making pimples look less noticeable overnight, it is important to manage patient expectations. Treating blemishes and preventing new ones can take up to eight weeks. Compliance to a skincare routine is paramount to success, and compounding allows the prescribing clinician to combine multiple topical medications into a single topical formula, making it easier for the patient to be compliant and consistent.
Acne can self-resolve; however, treatment is advised because:
It reduces the longevity of breakouts: Most teenage boys will continue to have breakouts until they are 20 or 25 years old. Teenage girls often struggle with acne into their 20s or longer, with 5% of women experiencing it into their 40s.
It mitigates further acne: What starts out as a few pimples can progress to more blackheads and whiteheads as well as deep, painful pimples. With the relationship between acne and diminished self-esteem, depression, and anxiety, preventative measures are advised.
It reduces scarring: All types of acne can cause scarring, which can be permanent. Early acne treatment is recommended to prevent scarring.
In order to target the different aspects of acne pathogenesis, combination therapy should be considered for most patients.
Patients should be cautioned about pregnancy risks with retinoid use.
The options for FDA-approved products to topically treat acne in children under the age of 12 years old have improved:
Benzoyl peroxide 2.5% / adapalene 1% gel, ages 9 and up
Tretinoin 0.05% micronized gel, ages 10 and up
After oral antibiotic therapy, it’s important to use topical products for maintenance, as they can offer continued efficacy months after discontinuation of antibiotics.
For mild acne, benzoyl peroxide alone, or in combination with topical antibiotics, is effective.
For moderate to severe acne, combine benzoyl peroxide with topical retinoids or systemic antibiotic therapy.
Retinoids may be used alone in primarily comedonal acne or in combination with topical or oral antimicrobials in mixed acne or primarily inflammatory acne. Inflammatory acne (particularly in adult females) can also be treated with topical dapsone 5% gel, and azelaic acid can be used to treat post-inflammatory hyperpigmentation. 2
|Type of Acne||First-Line Treatment Options||Compounded Options|
Benzoyl peroxide (BP) OR in topical combination therapy (either as a fixed combination product or separate components)
|Moderate & Severe||
Topical combination therapy (either as a fixed combination product or separate components)
For female patients, consider:
Custom in-office peel blends address everything from hyperpigmentation and skin tone to texture, acne, and more. Compounded chemical peels offer opportunities for increased margins without large minimum order quantities. Our peel solutions are offered as 120mL and yield a minimum of 20 treatments per bottle. Our pharmacists recommend use of a degreasing solution prior to all chemical peels as well as sodium bicarbonate topical spray for neutralizing hot spots and/or full treatment area. 4
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Trichloroacetic acid (TCA) 10-50%
Glycolic acid 20-50%
Salicylic acid 20-30%
Retinoic Acid boosters to layer with other peel solutions or for stand-alone use
VLS Multi-Acid Peel (Ascorbic Acid 1%/Salicylic Acid 2%/TCA 6%/Glycolic Acid 7%)
Rebrighten Peel (Salicylic Acid 7%/Lactic Acid 8%/Mandelic Acid 7%)
*Resorcinol has been on shortage in the U.S. for several months. When unavailable, Mandelic Acid 10% is used in its place.
Please note: information on this site is not intended as medical advice and the medications listed are not specific to any individual. The content is intended to inform as to what may be possible. Listed medications and/or compounded formulas are not necessarily those compounded at VLS Pharmacy & New Drug Loft . Please speak with your prescribing clinician about your specific needs.
As a 503A pharmacy, VLS Pharmacy* is committed to providing high-quality formulations of sterile and non-sterile compounded medications to you and your patients. Thanks to rigorous testing measures, we guarantee the safety, stability, purity, sterility, and quality of each formulation from preparation to administration. We use high-quality, active pharmaceutical ingredients sourced directly from PCCA, the leader of superior-quality APIs. Additionally, our pharmacy network meets USP <795> non-sterile standards and USP <797> sterile compounding guidelines. We’re also proud to host one of the first pharmaceutical labs built to USP <800> standards for handling hazardous drugs.
All of our medications undergo third-party potency and stability testing, and we complete high-sensitivity rapid endotoxin detection on-site. These measures allow for shorter delivery times to the patient without compromising our product quality. Because we source all of our active ingredients from PCCA, we also promise an additional level of pre-formulation testing, as PCCA ingredients undergo 14 high-level checks and reviews in order to pass inspection.
*New Drug Loft is also a 503A compounding pharmacy but specializes in strictly non-sterile compounding and therefore abides by USP <795> only.
For almost three decades, our team has been committed to serving our network of physicians and patients. We appreciate the opportunity to share our expertise as we develop advanced compounded formulations for those who need and want more than what is commercially available. We work hard to achieve excellence in all areas of our business -- from investment and advancement to personalized customer service and rigorous in-house and third-party safety testing and quality assurance. We are proud to prove the best, individualized medical solutions, compounded as needed.
Our 503A pharmacy network specializes in providing custom-made sterile and non-sterile compounded medications to physicians and patients across the country. Each prescription is crafted and delivered with a commitment to the highest level of quality, safety and service.
For more information about VLS Pharmacy, click here.