Wrinkles may begin at a young age, but become more pronounced in those over 40 years of age. They usually begin as fine lines, progressing to deep creases, folds and crepey skin. Wrinkles are oftentimes more noticeable in skin on exposed areas of the body (i.e. face, neck, hands). Wrinkles can be caused by a combination of factors such as age, exposure to ultraviolet light, and smoking. By your 40’s, wrinkles mostly appear with animation of the face; by your 50’s, the creases become more permanent; and, by your 60’s, your whole face may be covered with wrinkles. Wrinkles resulting from aging are often deep and accompanied by skin laxity. Those wrinkles due to sun exposure are often advanced with texture changes.  Based on research and patient testimonials, you may see improvement as early as 6 to 8 weeks; however, each patient is unique and time frames may differ. 

A usually harmless condition in which patches of skin are darker than the surrounding skin. It occurs when cells in the skin make too much melanin. Hyperpigmentation may appear as freckles, age spots, or larger areas of darkened skin on sun-exposed areas of the body, particularly on the face. Melasma is very common, affecting nearly 5 million Americans.  Based on research and patient testimonials, you may see improvement as early as 2 weeks; however, each patient is unique and time frames may differ. The medication only works while you are using it and melasma can also return with increased exposure to the sun or if you are on birth control. 

Rosacea is a chronic inflammatory skin disease that commonly occurs in the central part of your face. Patients often report persistent facial blushing or flushing along with more visible blood vessels around the nose and cheeks. Many people with rosacea also develop pimples on their face that resemble acne. In the US alone, more than 16 million patients are affected by rosacea, and worldwide incidences peak as high as 18%. Based on research and patient testimonials, you may see improvement as early as 6 to 8 weeks; however, each patient is unique and time frames may differ. 

Eczema, also known as atopic dermatitis, is a non-contagious inflammatory skin condition that affects up to 15 million Americans. It is a chronic disease characterized by dry, itchy skin that can weep clear fluid when scratched. A combination of genetic and environmental factors appears to be involved in the development of eczema. Eczema often appears on your inner elbow or behind your knees. You can also have it on your neck, wrists, and ankles. Based on research and patient testimonials, you may see improvement as early as 3 to 7 days; however, each patient is unique and time frames may differ.

Psoriasis causes patches of thick red skin and silvery scales that are thicker and more inflamed than with eczema. Patches are typically found on the elbows, knees, scalp, lower back, face, palms, and soles of feet, but can affect other places (fingernails, toenails, and mouth). The most common type of psoriasis is called plaque psoriasis. According to current studies, nearly 8 million people in the US have psoriasis.  Based on research and patient testimonials, you may see improvement as early as 3 to 7 days; however, each patient is unique and time frames may differ.

Keloid scars are a thick raised scar that can occur when you injure yourself. Keloid scars are commonly found on shoulders, cheeks, earlobes and chest. A keloid scar isn't typically harmful; however, these types of scars may cause emotional distress due its size color, and thickness.

Acne scars are the result of inflammation of acne blemishes. Some acne scars are shallow and may heal quickly; however, some may become deeper and more apparent. 

Stretch marks are indented streaks that commonly appear on the abdomen, hips, buttocks and breasts. The appearance of stretch marks vary depending on their age, what caused them, and where they are located on your body. Common variations include: indented streaks/lines, pink, red or purple streaks, light colored streaks or streaks cover large areas of your body. Anyone can develop stretch marks, but some factors that increase your chances of developing them include, but are not limited to; being pregnant, rapid growth of muscle, and/or rapid gain or lose of weight. 

Based on research and patient testimonials, you may see improvement as early as 2 months for new scars and up to 6 months for older scars; however, each patient is unique and time frames may differ.

Nail fungus affects millions of people, but many go months or even years without getting treatment. Toenail fungus commonly affects seniors with chronic medical conditions or more serious underlying conditions. Diabetes, circulatory problems, or immune-deficiency conditions can contribute to toenail fungus which is caused by an infection under the surface of the nail. It can lead to discomfort, pain, and may impair your ability to walk if left untreated. Many people don’t recognize the symptoms of toenail fungus, including white marks on the nail bed, distorted shape, discoloration, or a thickening of the nail.  It may affect one or several nails, and can affect ambulatory and non-ambulatory patients. Based on research and patient testimonials, you may see improvements in 48 to 52 weeks; however, each patient is unique and time frames may differ. 

Hair loss is a common issue that can affect both men and women, often leading to thinning hair, bald spots, or a receding hairline. It can be caused by genetics, aging, stress, hormonal changes, or medical conditions like alopecia. Hair loss can be temporary or permanent, depending on the cause, but there are treatments available to help slow it down or promote regrowth. Taking early steps and consulting a professional can make a big difference in managing hair loss.

Shingles is a viral infection that causes a painful rash. Although shingles can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso. Shingles is caused by the varicella-zoster virus — the same virus that causes chickenpox. After you've had chickenpox, the virus lies inactive in nerve tissue near your spinal cord and brain. Years later, the virus may reactivate as shingles.

The pain usually lasts 2 to 3 days before the development of a rash in the affected dermatome. However, some patients have presented with pain for approximately 1 week before development of a rash. Shingles generally lasts between 2 and 6 weeks. Most people only get shingles once,  but it is possible to get it two or more times.

A person with shingles can pass the virus to anyone who isn't immune to chickenpox. This usually occurs through direct contact with the open sores of the shingles rash. Once infected, the person will develop chickenpox, however, not shingles. Chickenpox can be dangerous for some people. Until your shingles blisters scab over, you are contagious and should avoid physical contact with anyone who hasn't yet had chickenpox or the chickenpox vaccine, especially people with weakened immune systems, pregnant women and newborns. Based on research and patient testimonials, you may see improvement as early as 1 to 2 weeks; however, each patient is unique and time frames may differ.

One size doesn’t fit all and every patient is unique. Drug compounding is the process of combining, mixing, or altering ingredients to create a medication tailored to the needs of a patient by a pharmacist as the result of a practitioner’s prescription drug order. While compounded medications are not FDA-approved, they serve an important patient need—especially when FDA-approved medication is not available for treatment. Our formulations are made to order in small batches to ensure freshness. The specific ingredients in your compounded formula will depend on your specific concerns and goals. It should be understood that your personal healthcare practitioner will make the final decision.

Yes! All of our compounded formulations, regardless of ingredients, are eligible for Flexible Spending Accounts (FSA) and Health Saving Accounts (HSA). 

• Khavkin J, Ellis DA. Aging skin: histology, physiology, and pathology. Facial Plast Surg Clin North Am. 2011 May;19(2):229-34. doi: 10.1016/j.fsc.2011.04.003. PMID: 21763983.

• Schmidt JB, Binder M, Demschik G, Bieglmayer C, Reiner A. Treatment of skin aging with topical estrogens. Int J Dermatol. 1996 Sep;35(9):669-74. doi: 10.1111/j.1365-4362.1996.tb03701.x. PMID: 8876303. 

• Schmidt JB, Binder M, Macheiner W, Kainz C, Gitsch G, Bieglmayer C. Treatment of skin ageing symptoms in perimenopausal females with estrogen compounds. A pilot study. Maturitas. 1994 Nov;20(1):25-30. doi: 10.1016/0378-5122(94)90097-3. PMID: 7877517. 

• Bissett DL, Oblong JE, Berge CA. Niacinamide: A B vitamin that improves aging facial skin appearance. Dermatol Surg. 2005 Jul;31(7 Pt 2):860-5; discussion 865. doi: 10.1111/j.1524-4725.2005.31732. PMID: 16029679. 

• Fu JJ, Hillebrand GG, Raleigh P, Li J, Marmor MJ, Bertucci V, Grimes PE, Mandy SH, Perez MI, Weinkle SH, Kaczvinsky JR. A randomized, controlled comparative study of the wrinkle reduction benefits of a cosmetic niacinamide/peptide/retinyl propionate product regimen vs. a prescription 0.02% tretinoin product regimen. Br J Dermatol. 2010 Mar;162(3):647-54. doi: 10.1111/j.1365-2133.2009.09436.x. PMID: 20374604; PMCID: PMC2841824. 

• Humbert PG, Haftek M, Creidi P, Lapière C, Nusgens B, Richard A, Schmitt D, Rougier A, Zahouani H. Topical ascorbic acid on photoaged skin. Clinical, topographical and ultrastructural evaluation: double-blind study vs. placebo. Exp Dermatol. 2003 Jun;12(3):237-44. doi: 10.1034/j.1600-0625.2003.00008.x. PMID: 12823436.

• Buddenkotte J, Steinhoff M. Recent advances in understanding and managing rosacea. F1000Res. 2018 Dec 3;7:F1000 Faculty Rev-1885. doi: 10.12688/f1000research.16537.1. PMID: 30631431; PMCID: PMC6281021.

• van Zuuren EJ, Fedorowicz Z, Carter B, van der Linden MM, Charland L. Interventions for rosacea. Cochrane Database Syst Rev. 2015 Apr 28;2015(4):CD003262. doi: 10.1002/14651858.CD003262.pub5. PMID: 25919144; PMCID: PMC6481562. 

• Hoover RM, Erramouspe J. Role of Topical Oxymetazoline for Management of Erythematotelangiectatic Rosacea. Ann Pharmacother. 2018 Mar;52(3):263-267. doi: 10.1177/1060028017740139. Epub 2017 Nov 2. PMID: 29094614. 

• Gehring W. Nicotinic acid/niacinamide and the skin. J Cosmet Dermatol. 2004 Apr;3(2):88-93. doi: 10.1111/j.1473-2130.2004.00115.x. PMID: 17147561. 

• [Colón LE, Johnson LA, Gottschalk RW. Cumulative irritation potential among metronidazole gel 1%, metronidazole gel 0.75%, and azelaic acid gel 15%. Cutis. 2007 Apr;79(4):317-21. PMID: 17500380. [5] Lee VS, Davis GE. Culture-directed topical antibiotic treatment for chronic rhinosinusitis. Am J Rhinol Allergy. 2016 Nov 1;30(6):414-417. doi: 10.2500/ajra.2016.30.4380. PMID: 28124652; PMCID: PMC5108841

• Schmied C, Piletta PA, Saurat JH. Treatment of eczema with a mixture of triamcinolone acetonide and retinoic acid: a double-blind study. Dermatology. 1993;187(4):263-7. doi: 10.1159/000247260. PMID: 8274782. 

• Berman B, Bienstock L, Kuritzky L, Mayeaux EJ Jr, Tyring SK; Primary Care Education Consortium; Texas Academy of Family Physicians. Actinic keratoses: sequelae and treatments. Recommendations from a consensus panel. J Fam Pract. 2006 May;55(5):suppl 1-8. PMID: 16672155. 

• Schwartz JR. Zinc Pyrithione: A Topical Antimicrobial With Complex Pharmaceutics. J Drugs Dermatol. 2016 Feb;15(2):140-4. PMID: 26885780.

• Kang S, Kim KJ, Griffiths CE, Wong TY, Talwar HS, Fisher GJ, Gordon D, Hamilton TA, Ellis CN, Voorhees JJ. Topical tretinoin (retinoic acid) improves early stretch marks. Arch Dermatol. 1996 May;132(5):519-26. PMID: 8624148.

• Kwon SY, Park SD, Park K. Comparative effect of topical silicone gel and topical tretinoin cream for the prevention of hypertrophic scar and keloid formation and the improvement of scars. J Eur Acad Dermatol Venereol. 2014 Aug;28(8):1025-33. doi: 10.1111/jdv.12242. Epub 2013 Aug 19. PMID: 23952739.

• Palmieri B, Gozzi G, Palmieri G. Vitamin E added silicone gel sheets for treatment of hypertrophic scars and keloids. Int J Dermatol. 1995 Jul;34(7):506-9. doi: 10.1111/j.1365-4362.1995.tb00628.x. PMID: 7591421.

• O'Brien L, Jones DJ. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database Syst Rev. 2013 Sep 12;2013(9):CD003826. doi: 10.1002/14651858.CD003826.pub3. PMID: 24030657; PMCID: PMC7156908.

• Taheri A, Moradi Tuchayi S, Alinia H, Orscheln CS, Mansoori P, Feldman SR. Topical clobetasol in conjunction with topical tretinoin is effective in preventing scar formation after superficial partial-thickness burn ulcers of the skin: A retrospective study. J Dermatolog Treat. 2015;26(4):361-4. doi: 10.3109/09546634.2014.991677. Epub 2014 Dec 29. PMID: 25424054.

• Gehring W. Nicotinic acid/niacinamide and the skin. J Cosmet Dermatol. 2004 Apr;3(2):88-93. doi: 10.1111/j.1473-2130.2004.00115.x. PMID: 17147561.

• FDA Approved Drug Products: Lamisil AT (terbinafine)

• FDA Approved Drug Products: Lotrimin AF (clotrimazole)

• FDA Approved Drug Products: Diflucan (fluconazole)

• Marchese A, Orhan IE, Daglia M, Barbieri R, Di Lorenzo A, Nabavi SF, Gortzi O, Izadi M, Nabavi SM. Antibacterial and antifungal activities of thymol: 

A brief review of the literature. Food Chem. 2016 Nov 1;210:402-14. doi: 10.1016/j.foodchem.2016.04.111. Epub 2016 Apr 26. PMID: 27211664.

• Shanbhag P, Jani U. Drug Delivery through nails: Present and Future. Eur Soc for Trans Med 2016 Dec;2307-5023. doi.org/10.1016/j.nhtm.2017.01.002 

Received 7 December 2016 

• Dars S, Banwell HA, Matricciani L. The use of urea for the treatment of onychomycosis: a systematic review. J Foot Ankle Res. 2019 Apr 11;12:22. 

doi: 10.1186/s13047-019-0332-3. PMID: 31007722; PMCID: PMC6458736.

• Onychomycosis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/dermatologic-disorders/nail-disorders/onychomycosis. Accessed May 15, 2017.

• Goldstein AO, et al. Onychomycosis: Management. https://www.uptodate.com/contents/search. Accessed May 15, 2017.

• Toenail fungus. American Podiatric Medical Association. http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=1523. Accessed May 15, 2017.

• Varade RS, et al. Cutaneous fungal infections in the elderly. Clinics in Geriatric Medicine. 2013;29:461.

• Gupta AK, et al. Improved efficacy in onychomycosis therapy. Clinics in Dermatology. 2013;31:555.

• Westerberg DP, et al. Onychomycosis: Current trends in diagnosis and treatment. American Family Physician. 2013;88:762.

• AskMayoExpert. Fungal nail infection (onychomycosis). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.

• Nail care. Natural Medicines. https://naturalmedicines.therapeuticresearch.com/databases/medical-conditions/n/nail-care.aspx. Accessed May 17, 2017.

• Gibson LE (expert opinion). Mayo Clinic, Rochester, Minn. June 6, 2017.

All prescription medications require a valid and complete online consultation prior to approval and final pricing is determined. All compounded medications in the U.S. are considered off-label use. Licensed healthcare practitioners have the ability to prescribe compounds for off-label treatment, if they believe that it is an appropriate course of treatment.

The drug and medical information provided on this website is not meant to cover all adverse effects, drug interactions, warnings, medical uses, directions and precautions. The information provided is a medical resource and the judgment of your physician and/or healthcare practitioner should not be substituted. Premier Pharmacy has made every effort to ensure the information on the website is accurate and current based on present medical literature. 

Premier Pharmacy does not make any guarantees regarding the drug and medical information, and does not assume responsibility regarding the content. The drug safety and drug information contained on the website may be time sensitive and should not be utilized as a medical reference beyond the date hereof. The deficiency of a warning for prescription medications and vitamins provided on this website in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. 

If you have questions or concerns about your medications, please do not hesitate to contact us and/or your medical practitioner, including your pharmacist. Compound prescription products have not been tested or approved by the FDA for their intended use. No claims are made as to the safety, efficacy or use of this compound.