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The company references FSA and HSA payment eligibility and a cash-pay model in its published materials

Hypersensitivity, such as hives (urticaria) Respiratory Side Effects (particularly when used inhaled/nebulized): Chest tightness Bronchoconstriction (airway narrowing) Irritation of the bronchi or the trachea

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Even normal everyday things are painful to do as youre sitting on the nodules

Chen Z, Li G, Liu J

The concerns are formulation-level: copper ions can potentially destabilize some retinoid formulations, and layering both in one application step can increase irritation risk in sensitive users