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Customized Medications for Wound Care, Scars, Keloids & Burns
Our compounding professionals utilize a number of proprietary bases (gels and washes) to optimize the treatment of:
- Scars (old, new or surgical)
- Keloids
- Burns (from heat source or radiation)
- Stretch marks secondary to weight loss or gain, or rapid growth
- Athletic injuries
- Ulcerated leg wounds
- Acne scars
- Any skin condition needing barrier protection
We can suggest the most appropriate vehicle and work with practitioners to select active ingredients to best meet each patient's specific needs. Options include:
- Occlusive washes or PEG gels which are water-washable and designed to deliver Active Pharmaceutical Ingredients (APIs) topically to sensitive application sites such as wounds, burns, cuts, etc.
- A silicone gel formulated with antioxidants, emollients, and specialty ingredients to help with scarring.
- Gels and washes containing Meadowsweet Extract, potentially providing bacteriostatic, anti-inflammatory and healing properties, along with the ability to deliver APIs topically to sensitive wound sites.
Water-washable preparations allow for easy wound cleaning and debridement, and occlusive vehicles maintain a moist wound site providing an optimal healing environment.
TOPICAL SILICONE BASES FOR SCARS & OTHER SKIN CONDITIONS
Topical anhydrous silicone gels are non-greasy and have been widely used for barrier protection. Their occlusion and hydration properties are essential in scar management.1 Davey et al. believe that the relatively impermeable silicone gel acts in the same way as the stratum corneum. It reduces water loss and restores homeostasis to the scar, thereby reducing capillary hyperemia, collagen deposition, and hypertrophic scar formation.2
Gels are formulated with ingredients which are from the Amazon rainforest, such as Pracaxi Oil or Carapa Guaianensis (andiroba) Seed Oil. These are exceptional ingredients that promote skin renewal and healing while reducing inflammation. Emollients can be added for healing and soothing properties.
Our compounding pharmacist works together with other healthcare providers to customize prescription wound care solutions to meet specific patient needs and reduce wound complications, promote healing, discourage bacterial infection, and reduce pain and inflammation. We can compound medications for hard-to-heal wounds and pressure sores. For those who suffer from poor circulation to their extremities or who have a wound that is slow to heal, a preparation can be compounded to increase circulation to the area and enhance healing. Depending on whether the wound is painful or odorous, APIs such as misoprostol, phenytoin, metronidazole, nifedipine, and lidocaine can be added to the preparation. We can also add urea to create a moist environment, or papain if enzymes are desired.
APIs such as the following can be incorporated into the silicone gel base to help with pain or scar tissue:
- Collagenase
- Betamethasone Valerate
- Tranilast
- Tamoxifen Citrate
- Lipoic Acid
- EGCg
- Ascorbic Acid
The following are examples of Active Pharmaceutical Ingredients (APIs) that can be added in the optimal dose to the most appropriate base for topical use:
- Phenytoin to promote granulation and decrease exudate
- Metronidazole as an antibiotic and to control wound odor
- Misoprostol
- Lidocaine
- Nifedipine
- Pentoxifylline
- L-Arginine
- Ascorbic Acid
- Hyaluronic Acid
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs such as ketoprofen)
Ask us about:
- Emollient bases for wound hydration that are often helpful in treating decubitus ulcers
- Protective barrier ointments
- A "polyox bandage" (active ingredients in a powder form are insufflated onto a wound, forming a "bandage" once moistened) that is good for draining wounds
- Topical antibiotic solutions
We can also compound the following solutions for irrigation or iontophoresis:
- Dakin's Solution
- Acetic Acid
- Betamethasone Dipropionate
We are committed to solving medication problems by customizing medications based on findings in the medical literature. We use the finest pharmaceutical grade ingredients to formulate preparations in the optimal strength and dosage form for each patient.
RECENT RESEARCH OF CLINICAL INTEREST:
Effectiveness of Hyaluronic Acid for Treating Diabetic Foot
Diabetic foot ulceration is a major complication of diabetes mellitus. Hyaluronic acid (HA) is used in the treatment of diabetic foot. A meta-analysis was designed to evaluate if HA increased the complete healing rate of diabetic foot compared with controls. Chen et al. searched Medline, Cochrane, EMBASE, and Google Scholar (until January 31, 2014) databases for prospective randomized controlled trials that assessed the effectiveness of HA in treating foot ulcers resulting from diabetes. The primary outcome for the study was complete healing rate of the ulcer at 12 weeks. Three hundred twenty-eight patients were identified from four studies that evaluated the rate of healing of diabetic foot that were treated with HA or controls. Among the four studies, odd ratios (OR) ranged from 1.19 to 8.86, with the overall OR being 1.71. This meta-analysis strengthens the findings that HA is beneficial in treating diabetic foot by increasing the rate of wound healing and the findings support the use of HA in treating diabetic foot.3
References:
1 Widgerow et al., 2000; Mustoe, 2008
2 Burns. 17(4):313-9.
3 Dermatol Ther. 2014 Jul 14. [Epub ahead of print]
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