Stella+

• Encourage collagen and elastin — estriol, tretinoin, and GHK-Cu independently contribute to potential benefit^1,2,3
• May support the appearance of fine lines and wrinkles^.1,2,5
• Supports skin thickness and density^1,6
• Aids in skin hydration and barrier function^4,7
• Supports even skin tone^3,4
• Promotes skin maintenance and recovery^2,6
• Calms skin redness and irritation^2,4,5
• Address signs of skin aging ^1,7

Potential Side Effects

Potential side effects are most common during the first 4–6 weeks of use as the skin adjusts to the retinoid component. Most are mild and temporary.⁵

Common possible side effects:

• Dryness, flaking, redness/irritation — especially in the first 2–6 weeks; usually resolves with continued use and may be managed with less frequent use
• Mild stinging or tingling immediately after application
• Increased sun sensitivity — use of daily broad-spectrum SPF 30+ sunscreen is recommended
• Skin purging — a temporary increase in breakouts during the first 4–6 weeks as tretinoin accelerates cell turnover; this is not an allergy and typically resolves

Less common possible side effects:

• Hyperpigmentation or darkening at the application site — this can occur if the skin is irritated and then exposed to UV light
• Contact dermatitis or allergic reaction — rash, hives, or significant swelling; discontinue use and contact the prescriber if this occurs

Warnings and Precautions

• Avoid waxing, laser treatments, chemical peels, or dermabrasion to areas being managed with Stella+ without first consulting the prescriber
• Do not use near heat sources (e.g., heating pads, saunas) immediately after applying — increased blood flow to the skin may increase absorption and irritation
• Inform all healthcare providers that this cream is being used, especially before undergoing any facial procedures
• Do not apply during periods of significant skin barrier disruption (e.g., after laser resurfacing, chemical peels, or active sunburn) without specific provider guidance
• Pregnancy — topical tretinoin and estriol are nominally absorbed into circulation but are generally avoided during pregnancy
• Breastfeeding — use with caution; consult the prescriber
• Known allergy or hypersensitivity to estriol, tretinoin, GHK-Cu, niacinamide, or any other ingredient in the formulation
• History of estrogen-sensitive cancers (e.g., breast cancer, endometrial cancer) — use only under explicit specialist guidance due to the estriol component
• Active eczema, rosacea flare, seborrheic dermatitis, or significant skin barrier disruption at the intended application site — wait for resolution before initiating Stella+.
• Active facial infections (bacterial, viral, or fungal) at the application site

Drug Interactions

Stella+ is a topical cream with low systemic absorption, which limits the risk of systemic drug interactions. However, local skin interactions and the estriol component should be considered.⁸ Interactions to be aware of include:

• Other topical retinoids (tretinoin, adapalene, tazarotene, retinol products): Combining Stella+ with additional retinoid-containing products dramatically increases irritation risk — use only as directed and do not layer with other retinoid preparations
• Topical AHAs or BHAs (glycolic acid, salicylic acid, lactic acid): These exfoliants can compound retinoid-induced skin barrier disruption; avoid on the same nights as Stella+ until the skin has fully adapted⁵
• Benzoyl peroxide: Can oxidize and inactivate tretinoin — do not apply at the same time or on the same nights
• Products containing medicated or astringent ingredients (witch hazel, high-dose vitamin C, alcohol-based toners): May increase skin dryness and sensitivity when used alongside tretinoin³

Handling Requirements

• Keep away from children and pets

Stella+ works through three complementary pathways, each targeting a different aspect of supporting skin aging.

Estriol binds to estrogen receptors in the skin with a preferential affinity for ERβ over ERα. The receptors are found in high concentrations in dermal fibroblasts, the cells responsible for producing collagen and elastin.¹ When estrogen levels fall after menopause, fibroblast activity slows, collagen synthesis declines, and the skin thins and loses elasticity. Topical estriol helps restore this signaling locally. Topical estriol at 0.3% has been studied in clinical literature to promote epidermal thickness, support skin elasticity, and the appearance of wrinkle depth, with minimal systemic absorption.⁷

GHK-Cu (3%) is a copper-peptide complex naturally found in human blood plasma, where its levels drop from roughly 200 ng/mL at age 20 to about 80 ng/mL by age 60.⁶ When applied to the skin, GHK-Cu penetrates the outer layer and encourages fibroblasts to produce collagen, elastin, and glycosaminoglycans — the molecules that give skin its density and moisture. Importantly, it also regulates enzymes called matrix metalloproteinases (MMPs) and their inhibitors (TIMPs), carefully balancing collagen breakdown and rebuilding to produce a net gain in dermal tissue. Studies show GHK-Cu helps calm skin irritation, supports oxidative balance, may assist with wrinkle appearance, and supports new blood vessel formation — all of which help support skin maintenance and a youthful appearance.²

Tretinoin is an active vitamin A derivative that binds to retinoic acid receptors and activates genes that control cell differentiation, proliferation, and collagen production.³ It accelerates the natural turnover of surface skin cells (corneocytes) and encourages the growth of new cells beneath. It also supports the stratum corneum, the outermost skin layer, making it smooth, dense, and able to retain moisture. The 0.01% strength delivers the potential benefits of tretinoin while limiting the dryness and peeling associated with higher strengths.⁵

Niacinamide is an excipient with a supportive role to the active ingredients: it supports skin comfort (helping the skin tolerate tretinoin's initial adjustment period), helps inhibit the transfer of melanin to skin surface cells (supporting even tone), modulates ceramide production to support the skin barrier, and offers antioxidant support.⁴ The whole formulation is intended to offer a layered and synergistic approach that may provide added benefits compared to any one single ingredient.

IMPORTANT INFORMATION ABOUT COMPOUNDED MEDICATIONS

This medication has been compounded (custom-prepared) by a pharmacy. Compounded medications are specially prepared for individual patient needs based on a valid prescription and, as such, are not reviewed or approved by the U.S. Food and Drug Administration (FDA) for safety or efficacy. These statements have not been evaluated by the FDA.

This compounded preparation:

• Has not been approved by the FDA
• Has not undergone FDA review for safety, effectiveness, or quality
• Is prepared specifically for you based on your prescriber's order
• Individual outcomes may vary

Dosing is determined by the prescribing provider based on patient-specific factors. Always follow your healthcare provider's instructions. Compounded medications are not subject to FDA approval and lack the same safety and efficacy data as FDA-approved commercial medications. This medication should be prescribed and monitored by a licensed healthcare professional familiar with the condition being addressed and the specific applications of the medication.

1. Lephart ED. A review of the role of estrogen in dermal aging and facial attractiveness in women. J Cosmet Dermatol. 2018;17(3):282-288. doi:10.1111/jocd.12508
2. Pickart L, Vasquez-Soltero JM, Margolina A. GHK peptide as a natural modulator of multiple cellular pathways in skin regeneration. BioMed Research International. 2015;2015:648108. doi: 10.1155/2015/648108
3. Mukherjee S, Date A, Patravale V, Korting HC, Roeder A, Weindl G. Retinoids in the treatment of skin aging: an overview of clinical efficacy and safety. Clinical Interventions in Aging. 2006;1(4):327–348. doi: 10.2147/ciia.2006.1.4.327
4. Boo YC. Mechanistic basis and clinical evidence for the applications of nicotinamide (niacinamide) to control skin aging and pigmentation. Antioxidants. 2021;10(8):1315. doi: 10.3390/antiox10081315
5. Siddiqui MZ, Sonthalia S. Topical tretinoin for treating photoaging: a systematic review. International Journal of Women's Dermatology. 2022;8(1):e003. doi: 10.1097/JW9.0000000000000003
6. Pickart L, Margolina A. Regenerative and protective actions of the GHK-Cu peptide in the light of new gene data. International Journal of Molecular Sciences. 2018;19(7):1987. doi: 10.3390/ijms19071987
7. Schmidt JB, Binder M, Macheiner W, Klade H, Aberer E, Gebhart W. Treatment of skin aging symptoms in perimenopausal females with estrogen compounds: a pilot study. Maturitas. 1994;20(1):25–30. doi: 10.1016/0378-5122(94)90012-4
8. Andreano JM, Bergfeld WF, Medendorp SV. Tretinoin emollient cream 0.01% for the treatment of photoaged skin. Cleve Clin J Med. 1993;60(1):49-55. doi:10.3949/ccjm.60.1.49

Q: Is there a best time of day to apply Stella+?

A: Stella+ should always be applied at night. Tretinoin may increase skin sensitivity to the sun.

Q: How can I minimize potential side effects?

A: The tretinoin in Stella+ may cause a transient increase in irritation. The inclusion of niacinamide in our formulation not only aids tretinoin's role, but helps with tolerability. Night time application will also address any perceived irritation. Your provider may also have you titrate the medication, using it less frequently at first and gradually increasing frequency as tolerated.

Q: What makes Stella+ different from regular skincare products?

A: Most over-the-counter skincare products act superficially- hydrating, temporarily plumping, or providing antioxidant protection. Stella+ contains three prescription-strength active ingredients that are intended to work at the cellular level and may support skin concerns associated with hormonal changes, collagen loss, and reduced cell turnover.^1,3

Q: Who is Stella+ intended for?

A: Stella+ may potentially benefit a wide range of individuals but is especially suited to peri- and postmenopausal women whose skin is showing signs of hormonal aging: thinning, increased dryness, sagging, fine lines, and uneven tone. It may also be appropriate for adults with significant photodamage or premature skin aging.¹

Q: Can Stella+ be used in areas other than the face?

A: Stella+ may be used on the neck and décolletage as directed by the prescriber. These areas also contain estrogen receptors and are commonly affected by hormonal skin aging. Skin in these areas is often thin, so beginning with an intermittent regimen and titrating to nightly use as tolerated may be helpful. Always discuss expanded use areas with the prescribing provider before proceeding.

Q: Does Stella+ count as hormone regimen?

A: Stella+ contains estriol, a relatively weak estrogen, at 0.3%, a strength designed for localized facial application. Studies of topical estriol at this concentration exhibit minimal systemic absorption.⁷

Q: Is the tretinoin in Stella+ strong enough?

A: Tretinoin 0.01% is a gentle prescription concentration that has been studied. This low strength is also favored for helping minimize unwanted effects. It is noteworthy that the tretinoin acts additively with estriol and GHK-Cu through different pathways. It is the final curated medication with multiple ingredients working harmoniously that delivers potential benefits.^3,8