Compounding is the art and science of creating customized medications. Through the triad of the patient, pharmacist, and physician, a compounding pharmacy can prepare individualized prescriptions tailored to meet the specific needs of the patient. For a variety of reasons, whether it be unwanted side effects or allergies, many people (and pets) are not served by big pharma. One of our very first patients came to us with a severe burn covering her entire forearm. Scalded by steam and left in agony, she needed our help. She explained to us the last time she was scalded the physician ordered the commercially available Silvadene Cream. Despite Silvadene’s widespread use to treat and prevent bacterial infections for 2nd and 3rd degree burns, she broke out in a red itchy rash when she applied the cream. It was a rather unpleasant experience, making the burn worse- and she didn’t want to repeat that experience. Her physician wanted to prescribe a cream to help ease the pain but was uncertain of just what we were able to offer. Working with our pharmacist the two were able to come up with something better. As the compounding tech at our pharmacy, I got the pleasure of creating her customized prescription. The final preparation was a Lidocaine 5% and Prilocaine 2% (two anesthetics) in Pracasil-Plus Gel. Pracasil-Plus contains oil from the Pracaxi tree found in the Amazon Rainforest. A unique ingredient which has anti-inflammatory, antibacterial, anti-fungal, and antimicrobial properties. Below is a before and after picture showing how much this formulation helped heal her wound in just over two weeks.