Cream
Acne Cream
Triple-action topical for acne: antibiotic (clindamycin + erythromycin) and antifungal (ketoconazole). Covers bacterial and fungal acne.
Starting at $101/mo
RetinoidEveningGentle strength
Refine PM Cream
RxPrescription onlyApplied to the skin · Once a day · Retinoid · Evening · Gentle strength
Starting at $116/mo
Refine PM: a gentler evening retinoid with lower concentration, ideal for starting users or sensitive skin. Builds collagen and texture without heavy irritation.
Choose your plan
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Milder retinoid strength for easier tolerance
- Evening use allows recovery time and reduces sun photosensitivity
- Gradually builds results with consistent nightly use
Every plan includes
- Personalized, physician-guided plan
- Monthly, 3-month and 6-month plans
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is Refine PM?
(gentle-strength retinoid blend)
Refine PM is a formulation with retinoid at a lower concentration than standard tretinoin, combined with skin-soothing ingredients. It is designed for evening use, allowing the skin to recover overnight while building collagen and improving texture. Ideal for people new to retinoids or with easily irritated skin.
- How it is taken
- Applied to the skin
- How often
- Once a day
- Form
- Retinoid · Evening · Gentle strength
Milder
retinoid formulation for easier tolerance and daily use
Refine PM users typically see results by week 8-12 for texture; fine-line reduction takes longer. Sun protection is still essential.
How it works,
week by week.
Week 1–2
Start with the lowest concentration or gentlest form (EOS or Refine PM). Apply nightly to clean, completely dry skin.
Week 2–4
Retinization phase: redness, peeling, dryness are normal. Use a good moisturizer and SPF 30+ daily. Do not panic; continue use.
Week 4–8
Irritation subsides. Skin texture begins to improve. Pores may look smaller. Keep up daily sunscreen.
Month 2–6+
Fine lines fade, skin tone evens, acne improves. Results continue to deepen. Your physician may increase strength or frequency.
What you may notice,
and when.
Initial irritation expected
retinization phase resolves in 4-6 weeks
Sun protection essential
retinoids increase photosensitivity dramatically
Visible improvement
texture, fine lines, and tone improve over months
Collagen remodeling
cumulative benefit peaks at 6-12 months
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
Retinoids accelerate cell turnover and sun sensitivity. All retinoid users must use daily SPF 30+ sunscreen and avoid direct sun, especially when starting. Retinization (redness, peeling, dryness) is normal for weeks 2-4 and resolves with patience. Tretinoin is absolutely contraindicated in pregnancy and breastfeeding; other retinoids require caution. Do not use retinoids with vitamin C serums, benzoyl peroxide, or other active acids without spacing them 12+ hours apart. Tell your physician about any accutane history or severe acne. Avoid if you have eczema or severe barrier damage without medical clearance. Stop and seek care for severe redness, blistering, persistent peeling after month 2, or signs of allergic reaction.
The research behind
tretinoin.
Tretinoin is a retinoid, a form of vitamin A. It has some of the strongest controlled evidence of any topical for visible photoaging, from vehicle-controlled trials going back to 1988.
- Photoaging30 of 30 improved
Sixteen-week double-blind trial in which each person applied tretinoin to one forearm and vehicle cream to the other. All 30 who finished improved on the tretinoin side, and none improved on the vehicle side.
Weiss et al., JAMA 1988;259(4):527-32 - Face14 of 15 improved
In the same trial, half the participants also treated the face. Fourteen of the 15 treated with tretinoin improved, against none of the vehicle-treated faces; the difference was statistically significant.
Weiss et al., JAMA 1988;259(4):527-32 - Two years204 people
Up to two years of tretinoin emollient cream 0.05% on the whole face, against placebo, in moderate to severe facial photodamage. Treated people improved more on fine and coarse wrinkling, mottled pigment and sallowness, with no increase in atypia on histology. This is a stronger cream than most in the catalog.
Kang et al., Am J Clin Dermatol 2005;6(4):245-53
What the studies found
- All 30 patients who finished a 16-week trial improved on tretinoin-treated forearms and none on vehicle-treated forearms (Weiss et al., JAMA 1988).
- On the face, 14 of 15 treated patients improved, against none of the vehicle-treated faces (Weiss et al., JAMA 1988).
- Over two years, 0.05% tretinoin cream improved fine and coarse wrinkling and mottled pigment more than placebo, with no increase in atypia on histology (Kang et al., Am J Clin Dermatol 2005).
Trial results are for tretinoin at the strengths studied and are averages across people. The creams here are the pharmacy's versions with added ingredients; the trials tested tretinoin on its own. Compounded versions were not studied.
What this does not say
- Photoaging improvement is a visible and histologic change in the skin, not a reversal of age.
- Irritation was the main side effect in the 1988 trial; it is usually worst in the first weeks.
- The two-year trial used 0.05%, a different strength from most creams in the catalog (0.015% to 0.15%).
The research
behind it.
Lower retinoid concentration with soothing agents reduces irritation while maintaining cell turnover stimulation and collagen support.
Evening application provides an 8-12 hour recovery window before sun exposure, reducing photosensitivity risk compared to higher-strength daytime retinoids.
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I use Refine PM Cream?
Applied to the skin, once a day, at bedtime. The starting prescription is 1 pump each time. Your physician sets your own dose and it is printed on your label.
What exactly is in it?
GHK-Cu 0.5%, Tretinoin 0.05%, Dexpanthenol 0.3%, Vitamin E 2%, Hyaluronic Acid 1%.
How much arrives in each shipment?
1 tube at the starting strength, shipped to your door from a licensed US pharmacy.
Can I move to stronger tretinoin later?
Yes. Your physician may recommend starting with Refine PM to build tolerance, then transitioning to standard tretinoin after 3-6 months if your skin adapts well. This gradual escalation is a smart strategy.
Can I use retinoids if I'm pregnant?
Tretinoin: absolutely not. Other retinoids: discuss with your physician. Many prefer to avoid all retinoids during pregnancy and breastfeeding out of caution. Your OB-GYN and dermatologist must coordinate.
Do I have to use retinoids forever?
No. Once your skin improves, you may reduce frequency or switch to gentler OTC retinoids for maintenance. Some people use tretinoin 1-2× weekly indefinitely. Your physician helps you find a sustainable routine.
Can I combine tretinoin with other actives?
Spacing is key. If you use vitamin C, niacinamide, or other actives, use them at different times of day (e.g., tretinoin at night, vitamin C in morning) at least 12 hours apart. Benzoyl peroxide should be avoided with tretinoin.
What if my skin never adapts to retinoids?
Some people remain sensitive. Your physician may recommend gentler forms (EOS or Refine PM), lower frequency, or alternative anti-aging actives like niacinamide or peptides. You are not obligated to tolerate significant irritation.
Refine PM educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
More options
in this area.
Cream
Acne Cream with Tretinoin
Acne treatment combining antibiotics (clindamycin/erythromycin/ketoconazole) with tretinoin for faster clearance and post-acne healing.
Starting at $101/mo
Cream
Brightening Cream
Stronger prescription cream for stubborn melasma and dark spots: hydroquinone 6% with tretinoin, hydrocortisone, kojic acid and vitamins C and E. A short course, usually up to 8 weeks.
Starting at $109/mo
Cream
Clarity Cream
Acne and post-acne formula combining azelaic acid, niacinamide, clindamycin, and tretinoin. Anti-inflammatory and cell-renewing.
Starting at $109/mo
References
- 1.Tretinoin for photoaging and acne: a systematic review of randomized controlled trials. J Drugs Dermatol, 2018
- 2.Retinization in dermatology: understanding the timeline and managing irritation. Dermatol Ther, 2020
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.