# Immortals Medicine — Full Content > Prescriptions to support longevity. Online prescription and telehealth platform designed by longevity experts: licensed US physicians, FDA-regulated pharmacies, no membership fees, no insurance required, 50-state coverage. Home: https://medicine.immortals.com. ## About Immortals Medicine Immortals Medicine is an online prescription and telehealth platform designed by longevity experts. It gives adults access to licensed physicians, prescription medications, and ongoing health support — all from home. No membership fees, no insurance required. Medications are curated by longevity experts and shipped from US-based, FDA-regulated pharmacies. ### Why Immortals Medicine - Real doctors — Treatment recommendations from board-certified, US-licensed physicians authorized to prescribe in your state. - Unlimited follow-up — Chat with your doctor any time, 24/7, with a <12 hour response time via your secure portal. - No membership fee — No hidden fees. You only pay for your prescription if your physician approves treatment. - No insurance required — Medication shipped direct with transparent pricing. - 100% online — Skip waiting rooms and appointment lines. Complete everything from home. - Discreet shipping — If prescribed, medication arrives at your door in discreet packaging. - FDA-regulated pharmacies — All medication ships from US-based pharmacies. - Built with longevity experts — Protocols curated by the team behind Bryan Johnson's Blueprint. - 50-state coverage — Available nationwide. Specific medication availability may vary by state. ### About Bryan Johnson Bryan Johnson is the most measured human in history. After starting Blueprint at age 43, his results include: - Muscle: 98th percentile (all men) - Fat: 98th percentile optimal (all men) - Bone mineral density: 99th percentile (all ages) - Resting heart rate: elite athlete level - Fertility: top 99th percentile (all men) - Blood pressure: lower than 90% of 18-year-olds - Sleep: top quartile for 18-29-year-olds - Telomeres: equivalent to a 10-15-year-old - Epigenetic speed of aging: 0.48 - Better blood sugar control than 99% of 18-25-year-olds "When I started Blueprint, I was a broken-down 43 year old. Sugar cereal and soda as a kid, a decade of chronic depression, and 20 years of sleep deprivation. I was overweight, my joints hurt, and I was losing my hair. Five years later, I'm surprised. Really surprised. I may be the healthiest human alive." "I'm sharing everything my team and I have learned over the past few years, spending millions of dollars researching, experimenting, and measuring. I want everyone to feel this good. Immortals Medicine is doing for you what my team did for me, at a fraction of the cost and effort." More: https://medicine.immortals.com ## How it works 1. Medical intake — Answer a few questions about your medical history, health goals, and treatment preferences. 2. Doctor review — A US-licensed specialist reviews your answers and recommends treatment, if appropriate. 3. Discreet delivery — Medication ships direct to your door in discreet packaging, if prescribed. 4. Unlimited follow-up — Message your doctor any time, 24/7, with a <12 hour response time. Start the quiz: https://medicine.immortals.com/quiz ## Treatment categories ### Support Longevity URL: https://medicine.immortals.com/categories/longevity Precision protocols to support healthy aging. Treatments in this category: - Metformin — https://medicine.immortals.com/treatments/metformin - Tadalafil — https://medicine.immortals.com/treatments/tadalafil ### Lose Weight URL: https://medicine.immortals.com/categories/weight-loss Prescription-strength treatment for sustainable weight management Treatments in this category: - Acarbose — https://medicine.immortals.com/treatments/acarbose - Metformin — https://medicine.immortals.com/treatments/metformin ### Renew Skin URL: https://medicine.immortals.com/categories/skin Dermatologist-grade treatments to support healthier, stronger skin Treatments in this category: - Tretinoin — https://medicine.immortals.com/treatments/tretinoin ### Support Menopause (for women) URL: https://medicine.immortals.com/categories/womens-health Hormone therapy designed for menopause symptom management Treatments in this category: - Estradiol — https://medicine.immortals.com/treatments/estradiol ### Regrow Hair URL: https://medicine.immortals.com/categories/hair Evidence-based treatments to help regrow and maintain hair Treatments in this category: - Minoxidil — https://medicine.immortals.com/treatments/minoxidil ### Better Sex (Men) (for men) URL: https://medicine.immortals.com/categories/sexual-function-men Prescription medications that can support sex-readiness for men Treatments in this category: - Tadalafil — https://medicine.immortals.com/treatments/tadalafil ### Metabolic Health URL: https://medicine.immortals.com/categories/metabolic Medications to support metabolic function and glucose management Treatments in this category: - Acarbose — https://medicine.immortals.com/treatments/acarbose - Metformin — https://medicine.immortals.com/treatments/metformin ## Treatments ### Acarbose URL: https://medicine.immortals.com/treatments/acarbose Categories: Metabolic Health, Lose Weight Formulation: TABLET; Route: ORAL Can slow carbohydrate digestion, flattening blood sugar spikes that may drive hunger and fat storage. Cautions: Make sure patient is hydrating well. Highly recommend using a CGM, especially if combining with other medications that affect blood glucose. Pricing options: - 25 mg, 270 tabs (90-day supply, billed quarterly): $75.00 — $25.00/mo. Take 25 mg up to 3x daily before meals - 25 mg, 90 tabs (30-day supply, billed monthly): $40.00 — $40.00/mo. Take 25 mg up to 3x daily before meals #### Why is Acarbose included? Every time you eat carbohydrates — bread, rice, pasta, fruit — your blood sugar rises, and your body responds by releasing a surge of insulin. Insulin is your body's fat-storage hormone: when it spikes, fat burning stops and fat storing begins. It also causes your blood sugar to dip afterward, which can trigger hunger and cravings. Acarbose helps break this cycle by slowing down how quickly carbs are digested, smoothing out those spikes. The result is less insulin released, less fat stored, and often, fewer of those frustrating energy crashes and cravings that make sticking to a healthy diet so hard. How it works: Your gut uses special enzymes to break carbohydrates down into simple sugars that can enter your bloodstream. Acarbose temporarily blocks those enzymes so the carbs are digested much more slowly — spread over a longer stretch of your intestine rather than hitting your blood all at once. This smooths out the blood sugar curve after a meal. The carbs that make it to the lower gut are then fermented by gut bacteria, which produces compounds that signal fullness to your brain and feed the beneficial bacteria in your gut. For many individuals it works best if you take it with the very first bite of a carb-containing meal. Evidence: Multiple clinical trials confirm modest weight loss and reductions in belly fat in overweight people without diabetes. The STOP-NIDDM trial — a large international study — found that Acarbose not only reduced weight but also cut the risk of developing diabetes and had cardiovascular benefits in high-risk individuals. Average weight loss is typically modest, but many patients report fewer carb cravings and feeling more satisfied after meals — effects that make other changes often easier to sustain. Limitations: The most common side effects are gas, bloating, and loose stools — and they're common enough that you should expect them, especially in the first few weeks. This happens because the undigested carbs fermenting in your gut produce gas. Symptoms usually settle down as your gut adjusts, and starting at a very low dose (one small tablet once a day with a meal) can help a lot. The effect is usually dependent on what you eat: it may have little impact if your meal is mostly protein and fat. It's not recommended for people with certain gut conditions or significant kidney or liver problems. Your healthcare provider needs to evaluate whether it's appropriate for you. #### From Bryan "FDA-approved for type 2 diabetes. Improves metabolic health by inhibiting carbohydrate breakdown in the small intestine. I take this daily." #### Frequently asked questions **Who should take this medication?** Acarbose may be a good fit for patients looking to reduce post-meal blood sugar spikes and the insulin response that drives fat storage. **How it works** Providers typically recommend taking Acarbose with the very first bites of each main meal. It works locally in the gut by slowing down the enzymes that break carbohydrates into sugar — smoothing out the sharp rise in blood sugar that typically follows a meal. It generally won't work if taken after eating, so timing matters. **Side effects to expect** The most common side effects are gas, bloating, abdominal discomfort, and loose stools or diarrhea. These happen because undigested carbohydrates reach the lower gut, where bacteria ferment them. They tend to be worse with high-carb meals and at higher doses. For most patients, these symptoms improve over the first few weeks as your body adjusts — and eating lower-carb meals helps significantly. **Important: if you're also on insulin or a sulfonylurea** Acarbose on its own does not cause low blood sugar — but if combined with insulin or a sulfonylurea, low blood sugar is possible. If it happens, a provider may recommend glucose tablets or glucose gel (dextrose), not regular table sugar or juice. Because Acarbose slows sucrose digestion, ordinary sugar won't raise your blood glucose fast enough in an emergency. **Staying safe: hydration and monitoring** Make sure you're drinking enough water throughout the day, especially if experiencing any diarrhea. Seek urgent care immediately if you experience: Severe abdominal pain with persistent vomiting or diarrhea; Signs of dehydration: dizziness, fainting, or very little urine output; Yellowing of the skin or eyes, or dark-colored urine; Severe low blood sugar — confusion, fainting, or symptoms you cannot manage on your own ### Estradiol URL: https://medicine.immortals.com/treatments/estradiol Categories: Support Menopause Formulation: CREAM; Route: VAGINAL Low-dose local estrogen that can help reverse the vaginal and urinary changes of menopause. Pricing options: - 0.010%, 42.5 grams (90-day supply, billed quarterly): $78.00 — $26.00/mo. Apply 0.5 g twice weekly vaginally #### Why is Estradiol Vaginal Cream included? Menopause causes estrogen levels to drop sharply, and the vaginal and urinary tract tissues are particularly sensitive to this change. The tissue lining the vagina, urethra, and bladder needs estrogen to stay healthy — thick, moist, and resilient. Without it, these tissues gradually thin and dry out (a condition called genitourinary syndrome of menopause, or GSM), which may cause vaginal dryness, painful sex, urinary urgency, and frequent urinary tract infections. Unlike hot flashes, which often improve over time, these vaginal changes can get worse the longer estrogen has been absent. Estradiol cream delivers a tiny amount of estrogen directly to the affected tissue — enough to restore it locally, without significantly raising estrogen levels in the rest of the body. How it works: Think of vaginal tissue like a garden that needs water. Estrogen keeps this tissue plump, lubricated, and acidic — an environment where protective bacteria (Lactobacillus) thrive and harmful bacteria can't easily take hold. After menopause, without estrogen, the tissue can thin, dry out, become more fragile, and the natural acidity drops. Estradiol cream, applied directly to the vagina, replenishes estrogen exactly where it's needed. The tissue absorbs it locally, which can help restore its healthy structure and acidity, and re-establish the protective bacterial environment. Because it stays local and less enters the bloodstream. Evidence: Multiple clinical trials confirm that local vaginal estrogen reverses the tissue changes of menopause, relieves dryness and painful sex, and significantly reduces recurring UTIs. Major medical organizations — including the North American Menopause Society (NAMS) and the American College of Obstetricians and Gynecologists (ACOG) — recommend it as first-line treatment for these symptoms. Limitations: This is not the same as systemic hormone replacement therapy (HRT). At the standard dose, topical Estradiol doesn't treat hot flashes, strengthen bones, or have the broader effects of HRT — it specifically targets vaginal and urinary tissue. Women with a history of breast cancer or other hormone-sensitive cancers should discuss this with their oncologist before starting. GSM is a chronic condition: symptoms return if treatment is stopped, so this is typically used on an ongoing basis. Oil-based creams can weaken latex condoms and diaphragms — use non-latex alternatives during sex if required. #### From Bryan "FDA-approved to help soothe menopause symptoms. A prescription, localized hormone therapy that can treat vaginal dryness, itching, burning, and painful intercourse." #### Frequently asked questions **Who should take this medication?** Vaginal Estradiol may be a good fit for patients experiencing vaginal dryness, burning, painful intercourse, or urinary symptoms related to low estrogen — most commonly during perimenopause or after menopause. It delivers estrogen locally, which means systemic absorption is much lower than oral or patch forms of hormone therapy. **How it works** Estradiol applied vaginally can restore moisture and tissue health to the vaginal lining by replenishing estrogen locally. Symptoms typically improve gradually over weeks to months of consistent use. **Side effects to expect** The most common side effects are local irritation, burning, itching, vaginal discharge, and occasional spotting — particularly in the early weeks of use. These usually settle as the tissue adjusts to treatment. **Seek urgent care immediately if you experience:** Unusual or unexplained vaginal bleeding New or changing breast symptoms Chest pain or sudden shortness of breath Painful swelling or redness in the leg ### Metformin URL: https://medicine.immortals.com/treatments/metformin Categories: Support Longevity, Metabolic Health, Lose Weight Formulation: TABLET; Route: ORAL Can improve insulin sensitivity, which helps reduce chronic metabolic stress. Cautions: Highly recommend using a CGM, especially if combining with other medications that affect blood glucose. Pricing options: - 500 mg, 180 tabs (90-day supply, billed quarterly): $60.00 — $20.00/mo. Take 500 mg daily; can titrate up to 1,000 mg/day - 500 mg, 60 tabs (30-day supply, billed monthly): $35.00 — $35.00/mo. Take 500 mg daily; can titrate up to 1,000 mg/day #### Why is Metformin included? Most people think of Metformin as a diabetes drug (and that's what the FDA has approved it for). But research also shows promise for its impact on metabolic function as we age. Providers can, at their discretion, prescribe Metformin off-label for longevity support. . At its core, Metformin helps lower chronic insulin levels and reduce glucose variability, both of which are key drivers of metabolic dysfunction and accelerated aging. It also influences nutrient-sensing pathways like AMPK, which play a central role in cellular energy balance, mitochondrial function, and longevity. By reducing insulin exposure and stabilizing blood sugar, Metformin can help create a more resilient internal environment, which over time supports better metabolic health and lowers the risk of chronic diseases that shorten healthspan. How it works: Think of insulin as a key that unlocks your cells so they can absorb sugar from your blood for energy. When that key stops working well — a condition called insulin resistance — your body pumps out more and more insulin to compensate. High insulin is a fat-storage signal: it tells your body to hold onto fat and makes it very hard to burn it. Metformin helps cells be more responsive to insulin again, so the body needs less of it. Less insulin means less fat storage and more fat burning. It also nudges the gut to release a hormone called GLP-1 — the same hormone targeted by popular weight loss drugs like Ozempic — which slows digestion and reduces hunger. Evidence: There are many large-scale clinical trials showing Metformin produces modest but real weight loss in people who are overweight but don't have diabetes. The strongest finding is from the Diabetes Prevention Program, a major US study that tracked thousands of people for over 10 years. Metformin was particularly good at helping people keep weight off long-term.. It won't give dramatic results on its own, but as part of a broader plan it's one of the most evidence-backed metabolic tools available. Limitations: The weight loss from Metformin alone is typically modest. It works best as a supporting player alongside diet and exercise, not as a standalone solution. The most common side effects are stomach-related: nausea, loose stools, and bloating, especially in the first few weeks. Starting at a low dose and taking it with food can make a big difference. Long-term use can also reduce absorption of vitamin B12, so regular blood tests and B12 supplements are typically recommended. It's not suitable for people with significant kidney problems. As with any medication, whether it's right for you is a conversation to have with your healthcare provider. #### From Bryan "FDA-approved for type 2 diabetes. Improves metabolic health by lowering blood glucose and aiding insulin sensitivity. I take this on 6-week cycles." #### Frequently asked questions **Who should take this medication?** Metformin may be a good fit for patients looking to improve insulin sensitivity, support metabolic health, and assist with weight management. As with any medication, whether it's right for you is a conversation to have with your healthcare provider. **How it works** Metformin works primarily by reducing the amount of glucose the liver releases into the bloodstream and improving the body's sensitivity to insulin. This can help keep blood sugar more stable throughout the day, not just after meals. **Side effects to expect** The most common side effects are nausea, diarrhea, stomach cramping, and a metallic taste. These are usually temporary and improve as your body adjusts. Taking Metformin with food and starting on a low dose can often help reduce these symptoms. **Long-term: B12 monitoring** Long-term Metformin use can gradually reduce vitamin B12 absorption. Over time, this can contribute to anemia or nerve symptoms like numbness and tingling. It is typically recommended that B12 levels be checked periodically, and supplementation may be recommended by your provider. **Staying safe: hydration and monitoring** Make sure you're drinking enough water throughout the day, especially during illness. Seek urgent care immediately if you experience: Profound weakness, rapid or labored breathing, confusion, or marked sleepiness; Severe and persistent nausea, vomiting, or abdominal pain; New numbness or tingling, unexplained fatigue, or symptoms of anemia ### Minoxidil URL: https://medicine.immortals.com/treatments/minoxidil Categories: Regrow Hair Formulation: TABLET; Route: ORAL A clinically-backed treatment, often prescribed off-label for hair regrowth. Cautions: Do not stop taking suddenly without medical advice — this could cause a rapid rise in blood pressure. Pricing options: - 2.5mg, 90 tabs (90-day supply, billed quarterly): $45.00 — $15.00/mo. Take 1 tablet by mouth once a day with or without food. - 2.5mg, 30 tabs (30-day supply, billed monthly): $30.00 — $30.00/mo. Take 1 tablet by mouth once a day with or without food. - 1.25mg, 90 tabs (90-day supply, billed quarterly): $40.00 — $13.33/mo. Take 1 tablet by mouth once a day with or without food. - 1.25mg, 30 tabs (30-day supply, billed monthly): $30.00 — $30.00/mo. Take 1 tablet by mouth once a day with or without food. #### Why is Minoxidil included for hair restoration? Minoxidil as a hair loss treatment was discovered by accident. In the 1970s, it was being tested as a blood pressure medication when researchers noticed a remarkable side effect: patients were growing hair — on their scalps, faces, and bodies. Topical formulations were developed and received FDA approval for hair loss in 1988, making it the first approved hair loss treatment. Over 35 years later, it remains a strong evidence-backed option for male and female pattern hair loss. More recently, healthcare providers have begun prescribing Minoxidil off label for oral administration at a low-dose. This is easier for some people and can be more convenient than applying liquid or foam to the scalp every day. How it works: Hair grows in cycles: an active growing phase, a transitional phase, and a resting phase before the hair sheds. In one form of hair loss, a hormone called DHT (a form of testosterone) causes hair follicles to gradually shrink — each cycle produces a thinner, shorter hair until eventually nothing grows at all. Minoxidil doesn't block DHT, but it helps improve blood flow to the scalp, promotes delivery of more oxygen and nutrients to the shrinking follicles, and extends the growing phase of each hair cycle so hairs grow longer and thicker before shedding. Over time, some miniaturized follicles may partially recover. Evidence: Topical Minoxidil has been through dozens of clinical trials in both men and women over 35+ years and is FDA-approved in 2% and 5% formulations. The evidence base for oral Minoxidil in hair loss has grown substantially in recent years, though it remains more limited than for topical formulations. The most recent systematic review and meta-analysis (2025) identified 27 studies with 2,933 patients. Clinical adoption has risen rapidly as dermatologists see real-world results. Limitations: The first thing most people notice after starting Minoxidil is more hair shedding — which some might find alarming but is usually completely normal. The drug pushes resting follicles into the active growth phase, which first requires the old hair to fall out. The shedding phase usually passes within 4–8 weeks. The most important thing to understand is that Minoxidil is not a cure — it works only while you're using it. If someone stops treatment, the hair they've gained is likely to shed within a few months. It's a long-term commitment. For the oral version, some people experience unwanted hair growth on the face or body, or mild fluid retention — these are dose-dependent and usually manageable. Women should avoid during pregnancy. As with any medication, whether it's right for you is a conversation to have with your healthcare provider. #### From Bryan "FDA-approved for lowering blood pressure, often used off-label to regrow hair. I take this daily." I also use a topical Minoxidil formulation, Blueprint 302 Laser Cap, Peptide Shampoo, and Peptide Hair Serum for hair health. #### Frequently asked questions **Who should take this medication?** Oral Minoxidil may be a good fit for patients experiencing hair thinning or hair loss who want to stimulate regrowth and slow further shedding. It works best with consistent, long-term use and realistic expectations — results often develop gradually over months, not weeks. **How it works** Minoxidil works by stimulating hair follicles and prolonging the active growth phase of the hair cycle. Consistency is essential — stopping may gradually reverse any gains made. **Side effects to expect** For orally administered Minoxidil, common side effects include fluid retention, lightheadedness, and occasionally headaches. In higher doses it is used as a blood pressure medication, so if you have low blood pressure or you are already on blood pressure medications a provider will likely want you to monitor your blood pressure closely when starting Minoxidil. Many of these symptoms resolve on their own within a few days. Anyone taking oral Minoxidil should discuss unwanted side effects with their care provider. **Staying safe** ​ **Seek urgent care immediately if you experience:** Chest pain or a rapid, pounding heartbeat; Faintness or dizziness; Sudden unexplained weight gain; Swelling of the hands or feet. These require prompt evaluation. ### Tadalafil URL: https://medicine.immortals.com/treatments/tadalafil Categories: Support Longevity, Better Sex (Men) Formulation: TABLET; Route: ORAL More than a sexual health medication — Tadalafil can enhance blood flow and vascular health, foundational to supporting longevity. Pricing options: - 5 mg, 90 tabs (90-day supply, billed quarterly): $72.00 — $24.00/mo. Take 5 mg orally once daily - 5 mg, 30 tabs (30-day supply, billed monthly): $40.00 — $40.00/mo. Take 5 mg orally once daily #### Why is Tadalafil included? Tadalafil (Generic for Cialis) doesn't just treat erectile dysfunction (ED). The same process that causes ED (blood vessels losing their ability to relax and open properly) is often an early stage of cardiovascular disease. Because Tadalafil works by improving how blood vessels function throughout the entire body — not just in the penis — researchers started looking at whether it might also protect the heart and brain. The data so far is striking: large observational studies show men who take PDE5 inhibitors like Tadalafil have significantly lower rates of heart attack, heart failure, stroke, and even Alzheimer's disease. How it works: Relaxation of blood vessels depends on a chemical called nitric oxide — think of it as the "open the floodgates" signal. That signal gets broken down by an enzyme called PDE5. Tadalafil blocks PDE5, so the signal lasts longer and the blood vessels stay relaxed for longer. For men with ED, this can help make the body's natural response to arousal stronger and more reliable. The same relaxing effect works throughout the entire vascular system, which is why daily low-dose use may help support cardiovascular and endothelial health beyond sexual function. Evidence: Tadalafil has been through dozens of large clinical trials and has been used by millions worldwide since approval in the early 2000s. It's FDA-approved for erectile dysfunction (both on-demand and daily use), BPH (enlarged prostate), and pulmonary hypertension. It can also be prescribed off label, at a provider's discretion, to support cardiovascular function. A large observational UK study of over 80,000 men found that PDE5 inhibitor users had significantly lower rates of heart failure, stroke, and cardiovascular death. A 2023 study of over 2 million men found a 39% lower rate of Alzheimer's disease in Tadalafil users. Limitations: Tadalafil must never be combined with nitrate medications — such as nitroglycerin tablets carried for chest pain, or nitrate heart medications such as isosorbide mononitrate. The combination can cause a sudden, severe and potentially fatal drop in blood pressure. Men on blood pressure medications should also check with their healthcare provider, as Tadalafil can add to the blood pressure-lowering effect. #### From Bryan "FDA-approved for erectile dysfunction. Also associated with lower risk for major adverse cardiovascular events in men with ED. Studies suggest it may have cardioprotective effects. I take a low dose daily." #### Frequently asked questions **Who should take this medication?** Daily low-dose Tadalafil may be prescribed by your provider as part of a longevity-focused health strategy to support blood vessel and endothelial health. Because it improves circulation by relaxing blood vessels, it may also help patients with erectile dysfunction and urinary symptoms from an enlarged prostate (BPH). **How it works** Tadalafil relaxes smooth muscle in blood vessel walls, improving blood flow throughout the body. When taken daily at a low dose, it can maintain steady levels in the bloodstream, supporting vascular function and also improving erectile function for many patients. **Side effects to expect** The most common side effects include headache, facial flushing, nasal congestion, indigestion or heartburn, back or muscle aches, and occasional lightheadedness. These are typically mild and often improve as the body adjusts. **Seek urgent care immediately if you experience:** Chest pain, especially if you might need nitrate medication; Severe dizziness or fainting; An erection lasting longer than 4 hours; Sudden vision loss or sudden hearing changes ### Tretinoin URL: https://medicine.immortals.com/treatments/tretinoin Categories: Renew Skin Formulation: CREAM; Route: TOPICAL A topical cream shown in large-scale studies to help rebuild collagen and strengthen skin. Cautions: Wash face and add sunscreen before sun exposure. Do a test with medication to a small area before applying to face. Pricing options: - 0.025%, 60 grams (90-day supply, billed quarterly): $75.00 — $25.00/mo. Apply a pea-sized amount to face nightly as tolerated - 0.025%, 20 grams (30-day supply, billed monthly): $45.00 — $45.00/mo. Apply a pea-sized amount to face nightly as tolerated #### Why is Tretinoin included for skin health? Walk into any skincare store and you'll find hundreds of products claiming to fight aging — serums, creams, and oils with impressive ingredient lists and even more impressive price tags. Almost none of them have clinical proof that they actually change the structure of your skin. Tretinoin is an exception. It's backed by over 50 years of research, including studies where researchers took biopsies (small skin samples) before and after treatment and could see — under a microscope — that the skin had rebuilt itself: more collagen, thicker skin, new blood vessels. How it works: Your skin is constantly aging in two ways: naturally over time, and faster due to sun exposure. Sun damage is particularly harmful because UV light triggers enzymes that chew through your skin's collagen — the structural protein that keeps skin firm and smooth. Every unprotected sun exposure triggers a small burst of collagen destruction. Over years and decades, this adds up to thinner, looser, more wrinkled skin. Tretinoin works by switching on genes in skin cells that rebuild collagen, speeding up the turnover of old surface cells (revealing fresher skin underneath), and blocking collagen-destroying enzymes. Evidence: A landmark 1988 study was the first to demonstrate that Tretinoin visibly and measurably improved aged skin in a controlled trial. Subsequent studies confirmed these results under the microscope — actual biopsy-confirmed increases in collagen and skin thickness. Limitations: The first 4–8 weeks of Tretinoin use can be an adjustment period: people may experience redness, dryness, flaking, and sensitivity. This isn't an allergic reaction — it's your skin adjusting. Starting at a lower strength, alternating use a few nights a week, and applying a moisturizer before the Tretinoin, can help make this phase much more manageable. Many people who “give up” on Tretinoin do so during this adjustment phase, before they experience the benefits. Sun protection is non-negotiable — Tretinoin makes your skin more sensitive to UV, so wearing SPF 30+ every morning is a must. Tretinoin must not be used during pregnancy. Results take time: patients can typically expect visible improvement to take at least 3 or 6 months and often up to a year for the full collagen-rebuilding effect. #### From Bryan "FDA-approved to treat photoaging. I use this nightly alongside Blueprint Skincare." #### Frequently asked questions **Who should take this medication?** Tretinoin may be a good fit for patients looking to improve acne, skin texture, and fine lines over time. It works by accelerating skin collagen formation and decreases collagen breakdown, gradually improving skin health over time. Results require patience — meaningful improvement may take several months of consistent use. **How it works** Providers typically recommend applying Tretinoin to clean, dry skin. Before starting on the full face, it may be advisable to test a small area first to assess how skin responds. If significant irritation develops in the test area, hold off and reach out before proceeding. **Side effects to expect** Dryness, peeling, redness, burning, and irritation are common — especially in the first several weeks. This is a normal part of the adjustment period. Using Tretinoin too frequently or applying too much can make these symptoms worse. A gentle moisturizer can help manage dryness during this phase. **Sun sensitivity** Tretinoin significantly increases sensitivity to the sun. Wash your face in the morning and apply a broad-spectrum sunscreen every day— even on cloudy days. Skipping this step can lead to significant sunburn and post-inflammatory discoloration that is difficult to treat. **Seek urgent care if you experience:** Severe redness, swelling, blistering, or crusting of the skin; A significant sunburn while using Tretinoin. These may indicate a serious irritation reaction or dangerous sun damage that needs prompt evaluation. Patients with eczema-prone skin should be especially cautious, as the risk of severe irritation is higher. As with any medication, whether it's right for you is a conversation to have with your healthcare provider. ## Legal Canonical policies are hosted off-site and linked from every page: - Terms of Service: https://immortals.com/policies/terms-of-service - Privacy Policy: https://immortals.com/policies/privacy-policy - Telehealth Consent: https://immortals.com/pages/telehealth-and-pharmacy-informed-consent-authorization ## Frequently asked questions **What is Immortals Medicine?** Immortals Medicine is an online prescription and telehealth platform designed by longevity experts. It gives you access to licensed physicians, prescription medications, and ongoing health support, all from home. **Who is Immortals Medicine for?** Adults seeking convenient access to prescription longevity support, including weight loss, skin care, hair regrowth, hormone health, menopause, metabolic health, and sexual function. **Do I need to go to a clinic or pharmacy?** No. Immortals Medicine is 100% online. No waiting for appointments or pharmacy lines. If approved, your prescription ships directly to your door. **Will my doctor be licensed?** Yes. All doctors are US-licensed, board-certified specialists authorized to prescribe medications in your state. **Is this real medical care or just wellness advice?** Immortals Medicine provides legitimate telehealth medical care, including physician evaluations and prescription medications when clinically appropriate. **How much does the medication cost?** The cost varies depending on the type and amount of medication. You will see the price before making payment. You are only charged if your physician approves your treatment. **Where do prescriptions ship from?** Medication ships direct to your door from US-based, FDA-regulated pharmacies. **Where is Immortals Medicine available?** Available nationwide with 50-state coverage. Availability of specific medications may vary by state. **How do I reach support?** Email medicine@immortals.com. ## Disclaimer These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Results may vary. Always consult a licensed healthcare provider before starting, stopping, or changing any medication.