What Are Compounded Creams And How Can They Help?

Compounded creams can be used for a variety of conditions and can help with reduce symptoms, pain, and swelling.

In the pharmacy, one of our most common compounding requests is for compounded creams and topical medications. These medications allow patients to access the treatments they need in a delivery format or dose that’s easier to use and more appropriate for their illness.

In an effort to help you understand whether compounded creams may be right to you, we want to help you build your knowledge on the subject. Use the information you find here to learn more about this valuable treatment option.

First: What is Compounding?

Compounding is the process of creating a medication from scratch by mixing base ingredients. Unlike commercial medication production, compounding occurs on a much smaller, personalized scale, often right within the pharmacy itself.

Instead of simply doling out a pre-formulated medication, your pharmacist combines multiple base ingredients to create a brand-new formula personalized to your illness or needs.

Pharmacists compound many different forms of medicine, including:

• Pills,
• Lozenges
• Patches
• Injections
• Parenteral medications
• Hormones
• Even, in some cases, non-traditional delivery formats like candies or lollipops

Whatever the format, our main goal is to make medications safer, easier to take, and more suitable for the individual patient rather than just their condition.

When compounding creams, we combine multiple active and inactive ingredients to create a “compounded” formula. This differs from issuing a standard commercial medication because most commercial medicated creams come pre-formulated, pre-packaged doses, even before they even reach the pharmacy.

What Exactly are Compounded Creams?

Compounded creams are medications or formulas that are directly applied to the skin to aid pain and swelling, relieve skin conditions, or reduce symptoms from certain systemic conditions.

They may be used specifically, such as in the treatment of localized skin conditions like Psoriasis, or indirectly, such as in the use of topical hormones to treat Menopause.

Compounded creams, by definition, typically contain less than 20 percent water and no more than 50 percent standard compounding carriers (like hydrocarbons, waxes, or polyols). There are some exceptions to this rule, but this is the most common definition used in the pharmacy when comparing compounded creams to other topicals.

Topical Creams Vs. Alternatives

Despite the label “cream,” not every topical medication is a cream. True topical compounded creams fall into two formulaic categories: those made using a water-in-oil mixture, and those using an oil-in-water mixture. Additionally, most have a thick, creamy, or opaque appearance, although exact color can vary.

While common in medicine, creams are far from the only form of compounded topical medication pharmacists work with. Other topical dosage delivery formats include:

• Topical gels
• Lotions
• Salves
• Ointments
• Suppositories
• Pastes
• Liniments

Similarly, these delivery formats are applied directly to the skin or affected area to get the most results. However, they may contain ingredients not found in creams. The may also contain drugs that simply do not absorb well in the form of a cream.

Some people use the term “compounded creams” interchangeably with the term “topical medication,” especially in the case of gels, lotions, salves, ointments, and other formulas similar in consistency to cream. This definition is technically inaccurate. However, topical alternatives may be more or less suitable for treatment than creams in the treatment of specific conditions.

What are the Benefits of Compounded Creams?

We know through research that some drugs are just more effective when absorbed through the skin. We also know that compounded topicals can be extremely helpful for a long list of other reasons.

For example, creams show increased efficacy for treating localized issues like sunburns or skin conditions faster than, say, oral or inhalation medications.

This is just the beginning though, here’s a few more important benefits.

1. Avoid FPM

Topical creams avoid “first-pass metabolism” (FPM). FPM refers to the fact that the human body must process certain medications through the liver before the drug becomes effective. Drugs that avoid FPM have a reduced risk for serious liver complications; thus, they may be better for sensitive patient populations, such as children or the elderly.

2. Improve Usability

Using topical creams may improve patient compliance (how likely patients are to use their treatment as prescribed in the right dose every time). Patient compliance is a significant contributor to treatment failure. This is especially true in patients who experience anxiety or stress from anticipating undesired side effects, like nausea or dizziness, from oral or injectable medications. Creams often don’t produce the same side effects, meaning they are easier to tolerate.

3. Ability to Combine Medications

Compounding pharmacists frequently combine multiple medications into the same topical cream. This makes multifaceted treatment protocols easier and less time-consuming for the patient. Instead of needing to take multiple doses at different times of the day, the patient can use one cream with multiple ingredients instead. In certain situations, this may also make using medications more discreet.

4. Can Improve Effectiveness

Sometimes, combining ingredients is less about convenience and more about treatment effectiveness. For example, topical pain creams may contain both a numbing agent to reduce pain and an anti-inflammatory to relieve muscle spasms and swelling. Other formulas may contain both steroids and antibiotics to reduce inflammation while preventing or curing infection.

5. Certain Drugs Work Better

Topical creams show better efficacy for certain drugs, including hormones like estrogen and progesterone. When used to treat conditions like Menopause, vaginal dryness, or atrophied vaginal tissues, patients often experience an improvement in symptoms faster if they apply medications directly to the skin in the area most effective. This may be because stomach acid reduces bioavailability (how much of the dose is destroyed through digestion).

6. Can Moisturize the Area

Lastly, topical creams usually contain a gently moisturizing cold cream base. When applied topically, they condition the skin and reduce the risk of dryness, redness, or irritation. These are common experiences in patients who have sensitivities or allergies to drugs like steroids or anti-inflammatories. This is a particularly important factor for patients with inherently dry skin, Eczema, Psoriasis, Sjogren’s Syndrome, and other skin conditions.

Curious about whether or not topical and compounded creams are right for you? Every patient’s situation is unique. Give us a call or drop by the pharmacy; we’ll pull up your file and discuss your situation with you to determine the right compounded medication format for your condition.

Whether you’re reducing Menopause symptoms or treating a serious skin condition, we are your partner in better health and wellness.