There are many reasons why someone may prefer one type of product, like a cream, over another, like a gel, and medication is only effective if the patient uses it, so sometimes, this tailored approach simply comes down to personal preference.

Some patients or may have allergies or sensitivities and compounded medications can be made without certain ingredients or unnecessary additives and preservatives.

Compounded medications can provide the best dose, one that can deliver the needed benefits with a reduced risk of side effects.

Some patients require a unique blend of ingredients to achieve the results they are looking for, and dermatology compounding provides the personalization so these goals can be achieved.

Also known as all-trans retinoic acid (ATRA), Tretinoin is one of the most bioactive forms of retinoids, which are vitamin A derivatives. Originally studied over 30 years ago, Tretinoin is commonly applied topically in the treatment of acne vulgaris and as a palliative in treating features of photoaging such as facial wrinkles, roughened skin, and liver spots².

Tretinoin exerts its anti-inflammatory effects by binding with alpha, beta, and gamma retinoic acid receptors. Through this binding, Tretinoin increases cellular phagocytic responses as well as the modulation of other inflammatory events associated with acne vulgaris and related inflammatory skin disorders. Tretinoin administration suppresses the respiratory burst, with its consequent release of cytokines such as hydrogen peroxide, that characterizes inflammation. It also downregulates the production of nitric oxide, another key mediator of inflammation, by the inhibition of nitrous oxide synthase. Furthermore, Tretinoin has an inhibitory effect on the proteolytic enzymes released by neutrophils in the human body during phagocytosis³.

Ascorbic acid is a water-soluble vitamin found in fruits and vegetables such as citrus fruits and green peppers. It occurs as a white or slightly yellow crystal or powder with a slight acidic taste. It is an antiscorbutic product. On exposure to air and light it gradually darkens. In the dry state it is reasonably stable in air, but in solution it rapidly oxidizes. Ascorbic acid is a free radical, an antioxidant scavenger, and plays a major role in oxidation-reduction reactions. Ascorbic acid is a cofactor for enzymes involved in the biosynthesis of collagen (essential for tissue maintenance and repair), carnitine, and neurotransmitters. Humans cannot synthesize ascorbic acid endogenously and a lack of dietary intake can lead to scurvy. Vitamin C is most frequently used as a nutritional supplement. It is also used as an adjunct treatment of idiopathic methemoglobinemia and with deferoxamine in the treatment of chronic iron toxicity⁴.

Ascorbate deficiency lowers the activity of microsomal drug-metabolizing enzymes and cytochrome P-450 electron transport. In the absence of vitamin C, impaired collagen formation occurs due to a deficiency in the hydroxylation of procollagen and collagen. Non-hydroxylated collagen is unstable, and the normal processes of tissue repair cannot occur. This results in the various features of scurvy including capillary fragility manifested as hemorrhagic processes, delayed wound healing, and bony abnormalities⁵.