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doi: 10.1038/s41556-018-0178-0

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daily SPF use is strongly recommended 2 • Temporary skin darkening before brightening — some individuals experience this during the initial adjustment period with tretinoin • Localized flaking, tightness, or itching at the application site • Mild potential hormonal effects from estriol — systemic absorption from topical estrogen is generally considered low at compounded doses, but should be discussed with the provider 6 • Potential for systemic finasteride absorption — while topical finasteride is associated with lower systemic levels than oral forms, some absorption may occur