PRESCRIBED MEDICATIONS + SUPPLEMENT GUIDE

At BOUTIK DERMATOLOGY, we offer a range of highly effective topical acne medications to help you achieve clear and healthy skin. Our dermatologists are experts in prescribing the most suitable treatments tailored to your specific needs. From retinoids to antibiotics, our selection of topical medications work to combat acne by reducing inflammation, unclogging pores, and controlling excess sebum production. Our retinoids, such as tretinoin, help to accelerate skin cell turnover and prevent new acne formations. Antibiotics like clindamycin and erythromycin target acne-causing bacteria, while benzoyl peroxide effectively eliminates existing breakouts and prevents future ones. We also offer combination therapies to maximize the benefits of multiple ingredients. Whatever your acne concerns may be, our range of topical medications can help you achieve radiant and clear skin.

Winlevi (clascoterone) is a medication used for the topical treatment of acne vulgaris. It is indicated for use in individuals aged 12 years and older. Acne vulgaris is a common skin condition that occurs when hair follicles become clogged with oil and dead skin cells, leading to the formation of pimples, blackheads, and whiteheads.

Winlevi is unique because it is the first topical treatment for acne that contains clascoterone, which is a novel anti-androgen agent. It works by targeting and binding to androgen receptors in the skin. Androgens are hormones that play a role in the development of acne by stimulating the sebaceous glands to produce more oil (sebum), leading to clogged pores and inflammation.

By acting as an androgen receptor inhibitor, clascoterone helps to reduce sebum production and inflammation, which can help improve the appearance of acne lesions and prevent new ones from forming. This makes Winlevi an effective option for people looking for a topical treatment to manage mild to moderate acne.

Here's how Winlevi works to address acne:

1) Anti-androgen activity: Clascoterone, the active ingredient in Winlevi, acts as an androgen receptor inhibitor. It competes with androgens (such as testosterone) to bind to androgen receptors in the skin. By doing so, it blocks the effects of androgens on the sebaceous glands, reducing their sensitivity to androgen stimulation. As a result, sebum production is decreased.

2) Sebum reduction: By reducing sebum production, Winlevi helps prevent excessive oil accumulation on the skin's surface. This decreases the likelihood of pores becoming clogged and lowers the risk of developing new acne lesions.

3) Anti-inflammatory effects: Acne is an inflammatory skin condition, and inflammation plays a significant role in the development and progression of acne lesions. Winlevi's anti-inflammatory properties help to reduce the redness, swelling, and discomfort associated with acne.

Application: It is a topical medication, meaning it is applied directly to the skin. Cleanse the affected area and pat it dry before applying the medication.

Frequency: The usual recommendation is to apply a thin layer of Winlevi to the affected areas of the skin once daily, preferably in the evening. Your healthcare provider may adjust the frequency based on your response to the treatment.

Avoid Contact with Eyes, Lips, and Mucous Membranes: Take care to avoid getting the medication in or near the eyes, lips, or inside the nose, as it may cause irritation.

Side effects:

Application site reactions: These may include redness, itching, burning, or irritation at the site of application.

Skin dryness: Some users may experience dry skin as a side effect of Winlevi.

Peeling or flaking: In some cases, the skin may peel or flake due to the medication's exfoliating properties.

Rash: A skin rash may develop as a reaction to the medication.

Eye irritation: If the medication accidentally comes into contact with the eyes, it may cause irritation.

Worsening of acne: In rare cases, the use of Winlevi may lead to worsening of acne before it gets better. This is a phenomenon called "purging" and can be temporary.

Aczone (dapsone gel) is a topical medication that is used for the treatment of acne vulgaris. Acne vulgaris is a common skin condition characterized by the formation of pimples, blackheads, whiteheads, and sometimes deeper, painful cysts on the face, chest, back, and other areas with many oil glands. Dapsone is an antibiotic and anti-inflammatory agent that helps to reduce the inflammation associated with acne and also targets the bacteria (Propionibacterium acnes) that contribute to the development of acne lesions.

Sulfur and sulfacetamide are two commonly used topical medications for the treatment of acne and rosacea. They can be used separately or in combination, depending on the specific needs of the individual and the recommendations of a healthcare professional. Sulfur helps to unclog pores and reduce the formation of comedones (blackheads and whiteheads) by promoting the shedding of dead skin cells. It also has some anti-inflammatory effects, which can be beneficial for rosacea. Sulfacetamide is an antibiotic that belongs to the class of sulfonamides. It is effective against a wide range of bacteria, including Propionibacterium acnes, which is associated with acne breakouts. Sulfacetamide helps to reduce inflammation and control bacterial growth on the skin's surface, making it useful for both acne and rosacea treatment.

How to use sulfacetamide sodium-sulfur topical

This medication is for use on the skin only. Clean off make-up, oil and excess dirt from your face with a gentle cleanser before using this product. Wet the affected areas of skin before washing with this medication.

If your liquid form is a suspension, shake the bottle well before each use.

If you are using the liquid cleanser product, apply a generous layer of medication as directed by your doctor, usually once or twice daily. Gently massage it into the affected skin for 10 to 20 seconds until a full lather forms; rinse thoroughly and pat dry.

If you are using the cleansing cloth product, wash the affected areas with a cleansing cloth as directed by your doctor, usually once or twice daily. First wet your face with water. Then wet the cloth with a little water and work into a full lather. Cleanse your face with the cloth for 10-20 seconds. Do not get the lather into your eyes. Rinse thoroughly and pat dry.

If excessive drying occurs, you may need to rinse the cleanser off sooner or use it less often. Avoid getting any of this medication in the eyes, on the lips, or inside the nose or mouth. Consult your doctor or pharmacist for further details.

Side effects: sulfur odor, Redness, irritation or scaling of the skin may occur.

Azelaic acid is a topical medication used to treat various skin conditions, including acne, rosacea, and hyperpigmentation. It is a naturally occurring dicarboxylic acid found in wheat, barley, and rye, and it can also be produced synthetically for use in skincare products. Azelaic acid is commonly used for the treatment of mild to moderate acne and rosacea. It helps to reduce inflammation and the growth of acne-causing bacteria on the skin. Additionally, it has been found to be effective in improving post-inflammatory hyperpigmentation (PIH), which are dark spots that can result from acne breakouts. If you are pregnant or breastfeeding, it's essential to consult with your healthcare provider before using azelaic acid to ensure its safety during this time.

TOPICAL ANTIBIOTICS (e.g. Topical Clindamycin)

Clindamycin: Apply this product once or twice a day as instructed by

your physician.

NOTE: Unless otherwise instructed by your physician or unless you are

allergic, always use benzoyl peroxide in your acne treatment plan if you

are using topical clindamycin. Without benzoyl peroxide, the bacteria associated with your acne may develop resistance to clindamycin.

Brand Names: Acanya®, BenzaClin®, Duac®

Preferred pharmacy: Beverly Hills Apothecary

This combination medication is used to treat a certain type of acne (inflammatory acne vulgaris). It helps to decrease the number of acne pimples. Clindamycin is an antibiotic that stops the growth of acne-causing bacteria. Benzoyl peroxide can also stop the growth of bacteria as well as reduce oil production in the skin, helping keep your pores open.

During the first 3 weeks you are using benzoyl peroxide, your skin may become irritated. Also, your acne may seem to get worse before it gets better. If your skin problem has not improved within 4 to 6 weeks, check with your doctor.

WARNING: Benzoyl peroxide bleaches fabrics. Don’t get it on towels,

clothing, upholstery, pillowcases, linens, or carpeting.

SIDE EFFECTS: Benzoyl peroxide - drying, redness, bleaching of clothes,

towels and sheets, contact allergies.

Topical retinoids are medications derived from vitamin A that are applied to the skin to treat various dermatological conditions. They are commonly used to treat acne, but can also help with other skin concerns such as fine lines, wrinkles, and pigmentation irregularities.

How do topical retinoids work?

Topical retinoids work by regulating the turnover of skin cells. They help to unclog pores, reduce inflammation, promote collagen production, and encourage the development of new, healthy skin cells.

How should I apply topical retinoids? USE AT NIGHT

1. Cleanse: Begin by washing your face with a gentle cleanser and patting it dry.

2. Wait for dry skin: Wait for the skin to be completely dry before applying the topical retinoid. This helps to minimize irritation.

3. Apply a pea-sized amount to entire face using the 5 dot method: “5-dot” method. Start by placing a small pea-sized amount of the medication on your finger. Then, place “dots” in each of five locations of your face: Mid-forehead, each cheek, nose, and chin. Next, rub the medication into the entire area of skin - not just on individual pimples! Try to avoid the delicate skin around your eyes and corners of your mouth.

4. MOISTURIZE

What are the possible side effects?Some common side effects of topical retinoids include:

Dryness

Flaking or peeling

Redness or irritation

Temporary increase in acne breakouts (purging)

CAUTION: STOP 5-7 DAYS PRIOR TO Facial waxing and other skin procedures.

MINIMIZING IRRITATION WITH THE SANDWICH METHOD: Apply moisturizer before and after your pea size amount of retinoid.

HOW TO PAIR WITH SPOT TREATMENTS FOR HYPERPIGMENTATION: After the retinoid, apply moisturizer to your entire face, followed by the dark spot treatment directly to the dark spot. Allow the dark spot treatment to dry.

*Compounded prescriptions are not covered by insurance and are not available at non-compounding pharmacies such as CVS and Walgreens.

At BOUTIK DERMATOLOGY, we offer a range of treatment options for acne, and oral medications are one of them. Oral medications can be a beneficial addition to a comprehensive acne treatment plan. For moderate to severe cases of acne, oral antibiotics may be warranted. These antibiotics work by reducing the bacteria on the skin and decreasing inflammation. Another option for managing acne is oral isotretinoin, a powerful medication reserved for severe, cystic acne that has not responded to other treatments. Isotretinoin can provide long-lasting results by reducing oil production and preventing the formation of acne-causing plugs in the pores. It is essential to note that oral medications for acne require careful monitoring and may have potential side effects. At BOUTIK DERMATOLOGY, our highly trained dermatologist will evaluate your skin condition and develop an individualized treatment plan that may include oral medications to help you achieve clearer, healthier skin.

Isotretinoin is a medication primarily used for the treatment of severe acne. It is a synthetic form of vitamin A and is sold under various brand names, including Accutane, Roaccutane, and others. Isotretinoin works by reducing the production of sebum, which is the oily substance that can contribute to acne formation. It is typically prescribed when other acne treatments have not been effective.

Review isotretinoin in detail here.

Prescribing and taking isotretinoin requires consent, registration and compliance with ipledge. Maintaining adherence requires monthly office visits to start and maintain therapy while on the medication. Failure to adhere may result in gaps of therapy and/or ineligibility of staying on the medication.

Additionally, while taking isotretinoin, it is crucial to:

Take the medication exactly as prescribed and at the recommended dosage.

Follow any additional instructions regarding food intake, as isotretinoin absorption can be affected by food.

Use effective contraception methods if you are sexually active, as isotretinoin can cause severe birth defects if taken during pregnancy.

Attend all scheduled follow-up appointments and blood tests as advised by your healthcare provider.

Doxycycline, Minocycline, Erythromycin

Antibiotics decrease bacteria and inflammation, and are most effective for moderate-to-severe acne.

Minocycline, Doxycycline: Take one pill ONCE or TWICE per day, as instructed by your physician WITH FOOD.

Erythromycin, Azithromycin: Preferred in Pregnancy

NOTE: Always take these pills with lots of water. A pill stuck in the esophagus can cause significant burning and irritation. Avoid “popping” a pill right before bed and stay upright for at least one hour after taking a pill.

WARNING: Though less likely than doxycycline, minocycline may

increase your sensitivity to the sun, so practice excellent sun protection!

If you notice any of the following, stop using the medication and notify your health care provider: headaches; blurred vision; dizziness;sun sensitivity; heartburn-stomach pain; irritation of the esophagus; darkening of scars, gums, or teeth (more often with minocycline); nailchanges; yellowing of the eyes or skin (indicating possible liver disease);joint pains-and flu-like symptoms. Taking oral antibiotics with food may help with symptoms of upset stomach.

SIDE EFFECTS: Severe headaches; dizziness; sun sensitivity; irritation of the esophagus; discoloration of scars, gums, or teeth (often with minocycline); nail changes.

Spironolactone is a medication primarily used to treat conditions such as high blood pressure and fluid retention. However, dermatologists have also found it to be effective in managing acne, especially in women whose acne is influenced by hormonal factors.

How Does Spironolactone Work?

Spironolactone is an androgen receptor blocker, meaning it helps to inhibit the effects of androgens (a type of hormone) on the skin. Androgens can stimulate the production of sebum, which is an oily substance that can clog pores and lead to acne. By reducing androgen activity, spironolactone can help regulate sebum production and decrease the occurrence of acne breakouts.

Who Can Benefit from Spironolactone?

Spironolactone is typically prescribed to women with hormonal acne. It can be especially helpful for those who have not responded well to other acne treatments, such as topical medications or oral antibiotics. If you have tried various treatments without success, talk to your dermatologist to determine if spironolactone may be a suitable option for you.

How Is Spironolactone Taken?

Spironolactone is taken orally in pill form. The dosage and duration of treatment will vary depending on the individual and the severity of the acne. It is essential to follow your dermatologist's instructions carefully and take the medication as prescribed. Avoid increasing or decreasing the dosage without consulting your healthcare provider.

What Are the Potential Side Effects?

Like any medication, spironolactone can have side effects. These may include:

Increased urination

Dizziness or lightheadedness

Irregular menstrual periods

Breast tenderness or enlargement

Upset stomach or diarrhea

It's important to note that not everyone will experience these side effects, and they may vary in severity. If you notice any concerning side effects or have any questions or concerns, contact your dermatologist for guidance.

Pregnancy: Spironolactone should not be taken if you are pregnant or planning to become pregnant, as it can harm the developing fetus. Effective contraception is essential while taking this medication.

Blood Tests: Your dermatologist may recommend periodic blood tests to monitor electrolyte levels and kidney function while taking spironolactone.

Preferred pharmacy: Blink Pharmacy (Idaho)

EpiCeram Controlled Release Skin Barrier Emulsion is to be used to treat dry skin conditions and to manage and relieve the burning and itching associated with various types of dermatoses, including atopic dermatitis, irritant contact dermatitis, and radiation dermatitis.

You may use this prescription as many times throughout the day as a moisturizer.

EpiCeram helps to relieve dry, waxy skin by maintaining a moist wound and skin environment, which is beneficial to the healing process.

EpiCeram contains in its formulation components to address the 3 main attributes a barrier repair product should include:

- Humectants: to attract water to the epidermis

- Occlusives: to retard water loss

- Functional Ingredients: may help decrease inflammation, reduce itching, and provide agents to simulate the intercellular lipids

Side effects: Following the application of EpiCeram a temporary tingling sensation may occur (10-15 minutes).

Preferred pharmacy: Beverly Hills Apothecary

Opzelura (Ritlecitinib) is a Janus kinase (JAK) inhibitor medication used to treat moderate to severe atopic dermatitis in adults and adolescents. It helps with atopic dermatitis by targeting and inhibiting specific enzymes called JAK enzymes, which play a crucial role in the inflammatory process in the body.

Atopic dermatitis is a chronic inflammatory skin condition characterized by red, itchy, and inflamed skin. The condition is driven by an overactive immune response and an imbalance of certain cytokines (molecules involved in inflammation) in the skin.

JAK enzymes are intracellular signaling molecules that play a role in the transmission of signals from cytokines to the cell nucleus, leading to the production of pro-inflammatory substances. By inhibiting JAK enzymes, Opzelura reduces the signaling pathway that promotes inflammation in the skin, thereby helping to control the symptoms of atopic dermatitis.

By blocking the inflammatory process, Opzelura can alleviate the redness, itching, and other symptoms associated with atopic dermatitis, leading to improved skin condition and quality of life for individuals with moderate to severe forms of the condition.

Side effects: reactions at the Opzelura application site, such as: acne, itching, hives, warmth, discoloration, or deepening of skin color.

Preferred pharmacy: Beverly Hills Apothecary

Usage: Tacrolimus ointment helps reduce inflammatory skin reactions. It is prescribed for people with moderate-to-severe eczema, usually as an alternative to other treatments such as steroid creams or ointments. Can be used for additional inflammatory conditions: psoriasis, periorificial dermatitis and other rashes. It is applied topically (on to the skin) to reduce symptoms such as inflammation, redness and itching. Tacrolimus ointment is available in two strengths: 0.03% and 0.1%. Only the lower, 0.03% strength, is suitable for use by children. It will be prescribed initially by a skin specialist doctor.

Tacrolimus is also available as a medicine which is taken by mouth, but this is prescribed for a completely different medical condition.

Side effects: While tacrolimus ointment is generally safe and well-tolerated, some people may experience mild side effects such as skin irritation, burning, or itching at the application site. These effects are usually temporary and resolve on their own.

Recommend use for tacrolimus: twice daily as needed

Application: Wash your hands thoroughly before applying the ointment. Gently clean and dry the affected skin area before applying a thin layer of tacrolimus ointment. It is important to cover only the affected skin and not use it on unaffected areas.

On application, it may cause some sensitivity, therefore I recommend mixing the ointment with aquaphor.

Preferred pharmacy: Beverly Hills Apothecary

Elidel cream contains the active ingredient pimecrolimus, which belongs to a class of drugs called topical calcineurin inhibitors. Pimecrolimus works by inhibiting certain immune responses in the skin that cause inflammation and itching associated with eczema.Elidel cream is used to treat certain inflammatory skin conditions, primarily atopic dermatitis, which is also commonly known as eczema

Some common side effects of Elidel cream may include mild burning, stinging, itching, or redness at the application site. If this occurs it is recommended to to mix the cream with aquaphor.

Hydrocortisone, Desonide, Mometasone, Fluocinolone, Fluocinonide, Triamcinolone, Clobetasol

What are Topical Steroids?Topical steroids are medications that are used to reduce inflammation and itching in the skin. They are available in various forms such as creams, ointments, gels, lotions, and solutions. Topical steroids are frequently prescribed by dermatologists for a variety of skin conditions.

How do Topical Steroids Work?Topical steroids work by suppressing the inflammatory responses in the skin. They are highly effective in reducing redness, swelling, itching, and other symptoms associated with skin conditions such as eczema, psoriasis, dermatitis, and allergic reactions.

Applying Topical Steroids: Apply to affected areas once or twice daily as directed by your dermatologist. Stop after 2 weeks of continuous use unless instructed otherwise.

Considerations:

Unless directed by your dermatologist, avoid using potent topical steroids on sensitive areas such as the face, groin, and armpits.

Avoid long-term use: Prolonged use of potent topical steroids may cause side effects such as thinning of the skin, stretch marks, and other skin changes. Follow your dermatologist's instructions and do not exceed the prescribed treatment duration.

Possible Side Effects:Topical steroids are generally safe when used as directed, but they can have potential side effects, including:

Thinning of the skin

Changes in skin color

Skin irritation or burning sensation

At BOUTIK DERMATOLOGY, we understand the distress caused by hyperpigmentation and the desire for effective solutions. That's why we offer a range of topical curated prescriptions specifically tailored to address hyperpigmentation concerns. Our expert dermatologists meticulously analyze each individual's skin type, pigmentation severity, and underlying causes to create personalized prescriptions. These prescriptions incorporate powerful ingredients such as hydroquinone, kojic acid, and retinoids, known for their ability to inhibit melanin production, fade dark spots, and even out skin tone. Our carefully formulated topical treatments penetrate deep into the skin, targeting and reducing the appearance of hyperpigmentation while improving overall skin texture and clarity. With our topical curated prescriptions, you can look forward to brighter, more even-toned skin, boosting your confidence and radiating a youthful glow. Trust BOUTIK DERMATOLOGY to provide you with the personalized care and effective solutions you deserve.

Rx Dispensed in office

Hydroquinone is a topical skin-lightening agent used to treat various skin conditions that cause dark spots or hyperpigmentation. It works by inhibiting the activity of tyrosinase, an enzyme involved in the production of melanin, the pigment responsible for the color of the skin, hair, and eyes. Hydroquinone is primarily used to lighten areas of darkened skin such as age spots, melasma, freckles, and post-inflammatory hyperpigmentation (dark spots that develop after skin inflammation or injury). When using hydroquinone, it's crucial to protect your skin from the sun's harmful rays, as sun exposure can worsen hyperpigmentation. Sunscreen with high SPF should be applied daily.

How to Apply: Apply directly to affected areas at night using a qtip. Hydroquinone should be the last step in your night time skin routine.

Halo effect: Inadvertent application to the surrounding normal complexion skin can cause a ring of hypopigmentation around the treatment area. This is reversible.

WITH Hydroquinone-Tretinoin-Kojic Acid

SKNV Rx Dispensed in office

How to Apply: Apply directly to affected areas at night using a qtip. The brightening compound should be the last step in your night time skin routine.

Halo effect: Inadvertent application to the surrounding normal complexion skin can cause a ring of hypopigmentation around the treatment area. This is reversible.

WITH AZELAIC ACID-LACTIC ACID-VITAMIN C

SKNV Rx Dispensed in office

How to Apply: Apply to entire face before moisturizer. Do not spot treat.

Sold in office

Cysteamine is a molecule that has been studied for its potential use in treating hyperpigmentation disorders, including melasma. Sente is a skincare brand that has developed a product called "Sente Cysteamine Cream" specifically for the treatment of melasma.

Cysteamine works by inhibiting the production of melanin, the pigment responsible for skin color. In the context of melasma, excessive melanin production contributes to the development of dark patches on the skin. By reducing melanin production, cysteamine aims to lighten these patches and improve the appearance of melasma.

How to Use:

Step 1:

Apply to clean dry skin. If cleansing before use, wait at least 20 minutes until skin is completely dry.

Step 2:

Apply a thin layer of product daily, either morning or night. Leave on for 15 minutes.

Step 3:

Thoroughly wash off product with a mild cleanser then follow with moisturizer to help mitigate the slight Cysteamine scent.

If you have never used this product before or have sensitive skin, begin with every other day application, advancing to everyday use as tolerated. Do not leave on for more than 15 minutes.

Rx Dispensed in Office

Brightening wipes for acne, hyperpigmentation and preventative pre-procedure wipes. Contain ascorbic aid, kojic acid camellia sinensis (green tea) extract, arbutin for every day use. +Optional hydroquinone add on.

Instructions for use:

Apply wipe to affected area nightly. Stop if irritation occurs.

Discard after 30 days.

Tranexamic acid is an antifibrinolytic agent that is commonly used in medicine to prevent or control excessive bleeding. In recent years, oral tranexamic acid has been shown to be effective in melasma by reducing the production and activity of melanocytes, the cells responsible for producing the pigment melanin. By inhibiting melanin production, tranexamic acid may help to lighten the dark patches associated with melasma.

Contraindications: hormonal therapy (birth control, hormonal replacement therapy), active cancer, history of clotting (blood clot DVT, stroke, heart attack) and/or genetic increased risk of clotting.

How to use: Take one-half of a 650 mg tablet by mouth twice daily

Preferred pharmacy: Wilshire LeDoux Pharmacy

Apply topically once to twice daily as instructed by your physician.